Clinical Guidelines
WPATH Standards of Care, Version 8 (SOC8)
The World Professional Association for Transgender Health (WPATH) publishes the most widely referenced standards of care for transsexual health.
| Aspect | Key Recommendations |
|---|---|
| Eligibility | No minimum age for HRT; individualised care |
| Informed consent | Supported model |
| Hormone targets (trans fem) | E2: 100–200 pg/mL; T: < 50 ng/dL |
| Hormone targets (trans masc) | T: 300–1,000 ng/dL (trough) |
| Monitoring | Every 3 months in year 1, then every 6–12 months |
| Fertility preservation | Discuss before starting |
Full document: https://www.tandfonline.com/doi/full/10.1080/26895269.2022.2100644
Endocrine Society Guidelines (2017)
| Aspect | Key Recommendations |
|---|---|
| Trans feminine | Estradiol + AA; transdermal preferred for VTE risk reduction |
| Trans masculine | Testosterone therapy; monitor hematocrit |
| Bone health | Ensure adequate sex hormone levels |
| Monitoring | Hormone levels every 3 months (year 1), then annually |
Full document: https://academic.oup.com/jcem/article/102/11/3869/4157558
UCSF Transgender Care Guidelines
The UCSF guidelines provide practical, primary-care-focused recommendations.
Full document: https://transcare.ucsf.edu/guidelines