Estrogen (Feminizing) Therapy:
Labs to check prior to Rx: Lipid panel, A1c, CBC, CMP, PT/INR/PTT, estrogen (estradiol), testosterone
Medications: Estradiol 2mg-6mg PO daily (start with 2mg daily for first week, then increase to BID) _ androgen suppression with spironolactone 100mg-200mg daily; consider transdermal estrogen patch .025-4mg/d twice weekly, parenteral estradiol 2-10mg IM weekly
Re-check labs q2-3m for first year, q6m second year, then annually
Testosterone (Masculinizing) Therapy:
Labs to check prior to Rx: Lipid panel, A1c, CBC, CMP, PT/INR/PTT, estrogen (estradiol), testosterone, prolactin
Medications: Testosterone 100-200mg subcutaneous q2week; consider transdermal gel (second line)
Re-check labs q2-3m for first year, q6m second year, then annually
More Resources:
See TS Didactic hereGlassberg_TransgenderMedicine_3_27_21
See Endocrine Society 2017 Gudelines herejc.2017-01658
Comprehensive Guide: https://transcare.ucsf.edu/guidelines