Current Treatment Regimens for Transfeminine Individuals in the Nordic Countries

Background The demand for gender-affirming hormone therapy is increasing worldwide prompting a growing requirement for solid evidence for efficacy and safety. Aim We aimed to report on the organization of transgender care and the current clinical practice of feminizing hormone therapy in specialized clinics in the Nordic countries. Methods This study was a cross-sectional study performed as a questionnaire survey. A quantitative questionnaire was sent to 15 specialized clinics prescribing feminizing hormone therapy in the Nordic countries. Outcomes Twelve clinics responded to the inquiry. RESULTS The answers showed great variance in both number of clinics in each country as well as number of doctors responsible for prescribing gender-affirming hormone therapy. There was great difference in the width of the target ranges for estrogen plasma concentrations and in preferred route of administration for estrogens. Likewise, the risk assessment and monitoring of side effects were diverse. Clinical Implications To gather solid data on efficacy and safety of feminizing hormone therapy, the treatment regimens and the recording of side effects need to be consistent across the clinics responsible for the treatment of transfeminine patients. Strenghts & Limitations: This is to our knowledge the first report on treatment regimens for feminizing hormone treatment in the Nordic countries. The response rate was 80%; however, the included clinics only cover approximately 30% of the expected numbers of transfeminine individuals. CONCLUSION Despite the great diversity across clinics as regard to organization of clinics and to treatment regimens, the vast majority of clinics operated within the guidelines defined by The Endocrine Society.