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Assessing Readiness for Hormones

Informed consent requires a detailed discussion with the patient covering the risks and benefits of treatment. See below for sample forms. All treatment for minors requires parental/guardian consent, usually from both parents.

The only absolute medical contra-indication to initiating or maintaining estrogen or testosterone therapy is an estrogen- or testosterone-sensitive cancer. Other conditions such as obesity, cardiovascular disease, dyslipidemas, or other conditions should not preclude treatment in the setting of informed consent. While in the past, history of venous thromboembolism was a contraindication to estrogen hormone replacement, recent data shows that safer estrogen preparations, such as transdermal, do not preclude this. (Grade C)

If prescribing cross-sex hormones for a patient who has not used them before, assess for pre-existing physical and mental health conditions to aid in determining which preparation and dosage to prescribe (see section Hormone Administration). It is the clinician's responsibility to monitor the effects of cross-sex hormones.

Sample Consent Forms