Gender-Dysphoria / Gender-Incongruence

Published: September 2017
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  • Key Points 
  • Diagnosis 
  • Evaluation of Youth and Adults
  • Definitions of Terms Used in This Guideline
  • DSM-5 Criteria for Gender Dysphoria in Adolescents and Adults 
  • ICD-10 Criteria for Transsexualism Treatment 
  • Treatment of Adolescents
  • Hormonal Therapy for Transgender Adults 
  • Criteria for Gender-Affirming Hormone Therapy for Adults
  • Criteria for Gender-Affirming Hormone Therapy for Adolescents
  • Tanner Stages of Breast Development and Male External Genitalia
  • Baseline and Follow-Up Protocol During Suppression of Puberty
  • Protocol Induction of Puberty
  • Baseline and Follow-up Protocol During Induction of Puberty
  • Medical Risks Associated With Sex Hormone Therapy
  • Hormone Regimens in Transgender Persons
  • Masculinizing Effects in Transgender Males
  • Feminizing Effects in Transgender Females
  • Monitoring of Transgender Persons on Gender-Affirming Hormone Therapy
  • Adverse Outcome Prevention and Long-Term Care 
  • Criteria for Gender-Affirming Surgery that Affects Fertility
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Founded in 1916, The Endocrine Society is the world's oldest, largest, and most active organization devoted to research on hormones and the clinical practice of endocrinology. The Society works to foster a greater understanding of endocrinology amongst the general public and practitioners of complementary medical disciplines and to promote the interests of all endocrinologists at the national scientific research and health policy levels of government. The Hormone Foundation, the Society's public education affiliate, is a leading source of hormone-related health information for the public, physicians, allied health professionals and the media.


This pocket guide attempts to define principles of practice that should produce high-quality patient care. It is applicable to specialists, primary care, and providers at all levels. This pocket guide should not be considered exclusive of other methods of care reasonably directed at obtaining the same results. The ultimate judgment concerning the propriety of any course of conduct must be made by the clinician after consideration of each individual patient situation. Neither IGC, the medical associations, nor the authors endorse any product or service associated with the distributor of this clinical reference tool.


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