This checklist for initiating gender-affirming hormone treatment aligns with New Zealand and international best practice.
- General medical intake (medical history, family history, etc).
- Discuss the patient’s gender (sometimes referred to as “gender identity”).
- Discuss gender-affirming healthcare goals.
- Discuss expected outcomes of hormone therapy.
- Baseline blood work.
- Blood pressure, cardiovascular, and respiratory exams.
- Review of relevant health records – be aware these may contain misdiagnoses.
- Discuss contraindications to hormone therapy (hormone sensitive cancers, etc).
- Discuss treatment options, and the time frames for receiving these.
- Make recommendations for treatment, and discuss the options which the patient prefers.
- Review potential side effects of the specific treatments.
- Discuss fertility implications of the specific treatments – no guarantee of fertility or sterility.
- Discuss risk mitigation (e.g. smoking cessation support).
- Assess patient capacity to consent for hormone treatments (have they demonstrated the intellectual capacity to understand, give consent).
- If there are reasons to believe they do not have capacity to consent, refer to mental health services. Otherwise;
- Review and sign consent forms.
- Prescribe hormone treatments.
- Review recommendations for ongoing monitoring and maintenance.
You may wish to discuss further supports, as appropriate, if desired by your patient. However, this is not required to initiate treatment.
- Discuss support systems, such as family, peers, work, school.
- Discuss referrals, such as gender affirming surgeries, mental health services, transgender advocacy and peer support services.
You can find both clinical and plain language guides to hormone therapy on our website by clicking the button below.
- Code of Health and Disability Services Consumers’ Rights – Health and Disability Commissioner.
- Australian Informed Consent Standards of Care for Gender Affirming Hormone Therapy – Australian Professional Association for Transgender Health.
- A Primary Care Toolkit – Trans Care BC Provincial Health Services Authority.
- Guidelines for Gender Affirming Healthcare for Gender Diverse and Transgender Children, Young People and Adults in Aotearoa, New Zealand – Jeannie Oliphant, Jaimie Veale, Joe Macdonald, Richard Carroll, Rachel Johnson, Mo Harte, Cathy Stephenson, Jemima Bullock, David Cole, Patrick Manning.