This review discusses established transgender individuals on hormones who have reached their desired post-pubertal phenotype. Current guidelines have not clearly integrated specific considerations for the older population. This review focuses on changes in physiology with age, recommended maintenance therapy and safety evaluation to mitigate the risks of hormone therapy with a focus on the older population.
Treatment of gender-identity disorders is guided by standards set forth by the World Professional Association for Transgender Health (WPATH). Although not absolute, WPATH's eligibility criteria for hormone therapy and/or genital-reconstructive surgery include participation in psychotherapy. In addition, applicants for genital-reconstructive surgery are required to live at least one year full-time in the preferred gender role, a period referred to as the real-life experience (RLE).
