Diagnosis

Treatment

Document Overview

Design and created by Guideline Central in participation with the Endocrine Society.

Endocrine Treatment of Gender-Dysphoric/Gender-Incongruent Persons

Endocrine Society

Publication Date: Sep 13, 2017

Page Last Updated: May 6, 2026

Grading System

Quality of Evidence
Description of Evidence	High Quality	Moderate Quality	Low Quality	Very Low Quality
Description of Evidence	Well-performed RCTs Very strong evidence from unbiased observational studies	RCTs with some limitations Strong evidence from unbiased observational studies	RCTs with serious flaws Some evidence from observational studies	Unsystematic clinical observations Very indirect evidence from observational studies
Strength of Recommendation
Strong (1): "ES recommends..." Benefits clearly outweigh harms and burdens or vice versa	1-H	1-M	1-L	1-VL
Conditional (2): "ES suggests..." Benefits closely balanced with harms and burdens	2-H	2-M	2-L	2-VL
Ungraded Good Practice Statement		UGPS

Document Overview

Document Title: Endocrine Treatment of Gender-Dysphoric/Gender-Incongruent Persons

Authoring Society: Endocrine Society

Document Publication Date: Sep 13, 2017

Page Last Reviewed/Updated: May 6, 2026

Document Type: Guideline

Country of Publication: United States

Full Text Freely Available: Yes

Full Text Guideline: academic.oup.com/jcem/article/102/11/3869/4157558

Source Citation: Wylie C Hembree, Peggy T Cohen-Kettenis, Louis Gooren, Sabine E Hannema, Walter J Meyer, M Hassan Murad, Stephen M Rosenthal, Joshua D Safer, Vin Tangpricha, Guy G T’Sjoen, Endocrine Treatment of Gender-Dysphoric/Gender-Incongruent Persons: An Endocrine Society Clinical Practice Guideline, The Journal of Clinical Endocrinology & Metabolism, Volume 102, Issue 11, 1 November 2017, Pages 3869–3903, https://doi.org/10.1210/jc.2017-01658

Supplemental Implementation Resources

Document Scope, Criteria, and Use Cases

Document Objectives: To update the “Endocrine Treatment of Transsexual Persons: An Endocrine Society Clinical Practice Guideline,” published by the Endocrine Society in 2009.

Scope: Diagnosis, Management

Diseases/Conditions (MeSH)

D000068116 - Gender Dysphoria

D005783 - Gender Identity

D019968 - Sexual and Gender Disorders

D000068116 - Gender Dysphoria

D005783 - Gender Identity

D019968 - Sexual and Gender Disorders

Keywords: gender identity disorder, gender-dysphoric, gender-incongruent, transgender, transsexual

Target Patient Population: Gender-dysphoric/gender-incongruent persons

Inclusion Criteria: Male, Female, Adolescent, Adult

Health Care Settings: Ambulatory

Intended Users: Nurse, Nurse Practitioner, Physician, Physician Assistant

Recommendation Development Processes & Methodology

Number of Source Documents: 266

Includes peer/external review process?: Yes

Includes public comment process?: No

Methodologist involvement?: Yes

Patient involvement?: No

Includes multi-disciplinary group?: Yes

Includes systematic review?: Yes

Grades quality of strength of evidence?: Yes

Grades quality of strength of recommendation?: Yes

Discloses funding source?: Yes

Discloses conflicts of interest?: Yes

Includes benefits/harms analysis with recommendations?: Yes

Endocrine Treatment of Gender-Dysphoric/Gender-Incongruent Persons

Diagnosis

Evaluation of Youth and Adults

Treatment

Treatment of Adolescents

Hormonal Therapy for Transgender Adults

Adverse Outcome Prevention and Long-Term Care

Surgery for Sex Reassignment and Gender Confirmation

Grading System

Document Overview

Supplemental Implementation Resources

Document Scope, Criteria, and Use Cases

Recommendation Development Processes & Methodology