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European Society for Sexual Medicine Position Statement “Assessment and Hormonal Management in Adolescent and Adult Trans People, With Attention for Sexual Function and Satisfaction”

(2020) The Journal of Sexual Medicine. 17(4). p.570-584
Author
Organization
Abstract
Background There is a general lack of recommendations for and basic information tailored at sexologists and other health-care professionals for when they encounter trans people in their practice. Aim We present to clinicians an up-to-date overview of clinical consensus statements on trans health care with attention for sexual function and satisfaction. Methods The task force consisted of 7 clinicians experienced in trans health care, selected among European Society for Sexual Medicine (ESSM) scientific committee. The consensus was guided by clinical experience and a review of the available literature and by interactive discussions on trans health, with attention for sexual function and satisfaction where available. Outcomes The foci of the study are assessment and hormonal aspects of trans health care. Results As the available literature for direct recommendations was limited, most of the literature was used as background or indirect evidence. Clinical consensus statements were developed based on clinical experiences and the available literature. With the multiple barriers to care that many trans people experience, basic care principles still need to be stressed. We recommend that health-care professionals (HCPs) working with trans people recognize the diversity of genders, including male, female, and nonbinary individuals. In addition, HCPs assessing gender diverse children and adolescents should take a developmental approach that acknowledges the difference between prepubescent gender diverse children and pubescent gender diverse adolescents and trans adults. Furthermore, trans people seeking gender-affirming medical interventions should be assessed by HCPs with expertise in trans health care and gender-affirming psychological practice. If masculinization is desired, testosterone therapy with monitoring of serum sex steroid levels and signs of virilization is recommended. Similarly, if feminization is desired, we recommend estrogens and/or antiandrogen therapy with monitoring of serum sex steroid levels and signs of feminization. HCPs should be aware of the influence of hormonal therapy on sexual functioning and satisfaction. We recommend HCPs be aware of potential sexual problems during all surgical phases of treatment. Clinical Implications This is an up-to-date ESSM position statement. Strengths & Limitations These statements are based on the data that are currently available; however, it is vital to recognize that this is a rapidly changing field and that the literature, particularly in the field of sexual functioning and satisfaction, is limited. Conclusion This ESSM position statement provides relevant information and references to existing clinical guidelines with the aim of informing relevant HCPs on best practices when working with transgender people.
Keywords
Transgender, Nonbinary, Gender Diverse, Gender Incongruence, Feminization, Masculinization, Gender-Affirming Surgery, Sexual Functioning, Sexual Satisfaction

Citation

Please use this url to cite or link to this publication:

MLA
T’Sjoen, Guy, et al. “European Society for Sexual Medicine Position Statement ‘Assessment and Hormonal Management in Adolescent and Adult Trans People, With Attention for Sexual Function and Satisfaction.’” The Journal of Sexual Medicine, vol. 17, no. 4, 2020, pp. 570–84.
APA
T’Sjoen, G., Arcelus, J., De Vries, A. L. C., Fisher, A. D., Nieder, T. O., Özer, M., & Motmans, J. (2020). European Society for Sexual Medicine Position Statement “Assessment and Hormonal Management in Adolescent and Adult Trans People, With Attention for Sexual Function and Satisfaction.” The Journal of Sexual Medicine, 17(4), 570–584.
Chicago author-date
T’Sjoen, Guy, Jon Arcelus, Annelou L.C. De Vries, Alessandra D. Fisher, Timo O. Nieder, Müjde Özer, and Joz Motmans. 2020. “European Society for Sexual Medicine Position Statement ‘Assessment and Hormonal Management in Adolescent and Adult Trans People, With Attention for Sexual Function and Satisfaction.’” The Journal of Sexual Medicine 17 (4): 570–84.
Chicago author-date (all authors)
T’Sjoen, Guy, Jon Arcelus, Annelou L.C. De Vries, Alessandra D. Fisher, Timo O. Nieder, Müjde Özer, and Joz Motmans. 2020. “European Society for Sexual Medicine Position Statement ‘Assessment and Hormonal Management in Adolescent and Adult Trans People, With Attention for Sexual Function and Satisfaction.’” The Journal of Sexual Medicine 17 (4): 570–584.
Vancouver
1.
T’Sjoen G, Arcelus J, De Vries ALC, Fisher AD, Nieder TO, Özer M, et al. European Society for Sexual Medicine Position Statement “Assessment and Hormonal Management in Adolescent and Adult Trans People, With Attention for Sexual Function and Satisfaction.” The Journal of Sexual Medicine. 2020;17(4):570–84.
IEEE
[1]
G. T’Sjoen et al., “European Society for Sexual Medicine Position Statement ‘Assessment and Hormonal Management in Adolescent and Adult Trans People, With Attention for Sexual Function and Satisfaction,’” The Journal of Sexual Medicine, vol. 17, no. 4, pp. 570–584, 2020.
@article{8660203,
  abstract     = {Background
There is a general lack of recommendations for and basic information tailored at sexologists and other health-care professionals for when they encounter trans people in their practice.
Aim
We present to clinicians an up-to-date overview of clinical consensus statements on trans health care with attention for sexual function and satisfaction.

Methods
The task force consisted of 7 clinicians experienced in trans health care, selected among European Society for Sexual Medicine (ESSM) scientific committee. The consensus was guided by clinical experience and a review of the available literature and by interactive discussions on trans health, with attention for sexual function and satisfaction where available.

Outcomes
The foci of the study are assessment and hormonal aspects of trans health care.

Results
As the available literature for direct recommendations was limited, most of the literature was used as background or indirect evidence. Clinical consensus statements were developed based on clinical experiences and the available literature. With the multiple barriers to care that many trans people experience, basic care principles still need to be stressed. We recommend that health-care professionals (HCPs) working with trans people recognize the diversity of genders, including male, female, and nonbinary individuals. In addition, HCPs assessing gender diverse children and adolescents should take a developmental approach that acknowledges the difference between prepubescent gender diverse children and pubescent gender diverse adolescents and trans adults. Furthermore, trans people seeking gender-affirming medical interventions should be assessed by HCPs with expertise in trans health care and gender-affirming psychological practice. If masculinization is desired, testosterone therapy with monitoring of serum sex steroid levels and signs of virilization is recommended. Similarly, if feminization is desired, we recommend estrogens and/or antiandrogen therapy with monitoring of serum sex steroid levels and signs of feminization. HCPs should be aware of the influence of hormonal therapy on sexual functioning and satisfaction. We recommend HCPs be aware of potential sexual problems during all surgical phases of treatment.

Clinical Implications
This is an up-to-date ESSM position statement.

Strengths & Limitations
These statements are based on the data that are currently available; however, it is vital to recognize that this is a rapidly changing field and that the literature, particularly in the field of sexual functioning and satisfaction, is limited.
Conclusion
This ESSM position statement provides relevant information and references to existing clinical guidelines with the aim of informing relevant HCPs on best practices when working with transgender people.},
  author       = {T'Sjoen, Guy and Arcelus, Jon and De Vries, Annelou L.C. and Fisher, Alessandra D. and Nieder, Timo O. and Özer, Müjde and Motmans, Joz},
  issn         = {1743-6095},
  journal      = {The Journal of Sexual Medicine},
  keywords     = {Transgender,Nonbinary,Gender Diverse,Gender Incongruence,Feminization,Masculinization,Gender-Affirming Surgery,Sexual Functioning,Sexual Satisfaction},
  language     = {eng},
  number       = {4},
  pages        = {570--584},
  title        = {European Society for Sexual Medicine Position Statement “Assessment and Hormonal Management in Adolescent and Adult Trans People, With Attention for Sexual Function and Satisfaction”},
  url          = {http://dx.doi.org/10.1016/j.jsxm.2020.01.012},
  volume       = {17},
  year         = {2020},
}

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