Gender dysphoria and management of transgender patients
Adults in Australia can start gender-affirming hormones in primary care under the AusPATH informed-consent standards (2025). Know the regimens, the monitoring targets, the main risks (VTE with oral oestradiol, meningioma with high-dose cyproterone, erythrocytosis with testosterone) and the unsettled, state-dependent rules for under 18s.
Tier 2Condition
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- Gender incongruence (ICD-11) is a marked mismatch between experienced gender and sex assigned at birth. Gender dysphoria (DSM-5-TR) adds distress or impairment.
- Adults: AusPATH SOC 2025 supports GP-initiated hormones under informed consent. A diagnosis from a psychiatrist isn't a prerequisite.
- Under 18s: rules differ by state and are changing. The NHMRC is writing national guidelines.
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Sources
- AusPATH Australian Standards of Care for Informed Consent Gender-Affirming Hormone Therapy (AusPATH SOC 2025)AU/NZAustralian Professional Association for Trans Health, 2025 (published December 2025; final digital version 30 April 2026)
- Cheung AS, Wynne K, Erasmus J, Murray S, Zajac JD. Position statement on the hormonal management of adult transgender and gender diverse individuals. Med J Aust 2019;211:127-33AU/NZMedical Journal of Australia, 2019
- Australian Standards of Care and Treatment Guidelines for Trans and Gender Diverse Children and Adolescents, version 1.4AU/NZRoyal Children's Hospital Melbourne (endorsed by AusPATH), 2023
- Clinical practice guidelines for the care of trans and gender diverse people under 18 (in development)AU/NZNational Health and Medical Research Council, In development (commissioned 2025); check the NHMRC page for the current timeline
- Queensland Government response to the Vine review of puberty blockers and hormone therapy for minorsAU/NZQueensland Government, December 2025
- Hembree WC, Cohen-Kettenis PT, Gooren L et al. Endocrine treatment of gender-dysphoric/gender-incongruent persons: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 2017;102:3869-903Endocrine Society, 2017 (still current, November 2026)
- Coleman E, Radix AE, Bouman WP et al. Standards of Care for the Health of Transgender and Gender Diverse People, Version 8. Int J Transgend Health 2022;23(Suppl 1):S1-S259World Professional Association for Transgender Health, 2022
- Restrictions in use of cyproterone due to meningioma risk (daily doses of 10 mg or more)European Medicines Agency, February 2020
- Independent review of gender identity services for children and young people (Cass Review), final reportNHS England, 2024
- Last updated
- 14 November 2026
What changed
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