The hormonal management of adults with gender incongruence: what the non-specialist Endocrinologist needs to know. A position statement from the Society for Endocrinology

Abstract Individuals discharged from specialist gender identity services continue to require coordinated hormonal, medical, and psychosocial care. Despite this, there are limited standardised pathways for the transition of care from specialist clinics to ongoing primary care settings. This was developed by a multidisciplinary team including endocrinologists, specialist gender clinicians, reproductive medicine specialists and general practice. It draws on existing service specifications and shared-care protocols. The position statement emphasises the need for clear documentation at discharge from the gender identity clinic, including the hormone regimen, monitoring schedule, and risk stratification. It advocates a collaborative approach between specialist gender clinics and primary care providers. It also highlights the importance of patient education and empowerment for lifelong monitoring needs, lifestyle risk mitigation, such as smoking cessation, weight management, cardiovascular health, as well as contraception and fertility considerations. It provides guidance on when to seek specialist referral for hormonal management, and to adopt a multidisciplinary approach once complications or changes arise. This position statement supports minimal effective hormone dosing when appropriate, and the adoption of pragmatic strategies in later life or palliative contexts. A coordinated, patient-centred approach is key to optimizing long-term outcomes and ensuring safe, effective continuation of gender-affirming care.