Letters Section Editor: Jody W. Zylke, MD, Senior Editor.
Author Affiliations: University of Lethbridge, Lethbridge, Alberta, Canada (Dr Lawrence; email@example.com); and Centre for Addiction and Mental Health, Toronto, Ontario, Canada (Dr Zucker).
To the Editor: The article by Dr Spack1 concerning the management of persons with gender identity disorders misstated the prerequisites for cross-sex hormone therapy and omitted any explanation of transsexual subtypes. Spack stated that adults should be living full-time as the opposite gender to be eligible for cross-sex hormone therapy.
However, the Standards of Care2 (the consensus guidelines developed by the Harry Benjamin International Gender Dysphoria Association, which is now the World Professional Association for Transgender Health) rescinded this requirement in 1980. The most recent edition of the Standards of Care3 emphasizes that cross-sex hormone therapy can appropriately be prescribed not only for transgender persons who are not yet living as the opposite gender but also for those who have no intention of doing so.
Lawrence AA, Zucker KJ. Care for Transgender Persons. JAMA. 2013;309(20):2093–2094. doi:10.1001/jama.2013.4665
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