Uk Doctor Prescribing Cross
As charities call for NHS to lower age limit of 16 for hormones, parents are taking their children to private clinics for treatment
A doctor in Wales is prescribing cross-sex hormones to children as young as 12 who say they want to change sex, arguing that if they are confident of their gender identity they should not have to wait until 16 to get the treatment.
Helen Webberley, a GP in Wales, has set up a private gender clinic and recently started treating children, a handful of whom she has started on cross-sex hormones, including a 12-year-old.
He had been on puberty blockers since the age of nine, said Webberley. He would have to now wait until 16 to get testosterone. This child has always been a boy, never worn a dress, always played with boys. He was so ready, his mates are starting puberty and hes desperate to start puberty. I felt and the mother felt and the child felt it was the right time, so that childs now on cross-sex hormones, said Webberley, whose practice does not breach any current guidelines or laws.
Dr James Barrett, a consultant psychiatrist at the Charing Cross clinic, the oldest gender identity service in the UK, said he had concerns about treating children with cross-sex hormones.
He also expressed concern about the potential lack of clinical support for patients attending Webberleys clinic, many of whom she interacts with electronically via email, telephone and Skype though she insists on face-to-face sessions for children.
Hormone Therapy For Adults
The aim of hormone therapy is to make you more comfortable with yourself, both in terms of physical appearance and how you feel. The hormones usually need to be taken for the rest of your life, even if you have gender surgery.
It’s important to remember that hormone therapy is only one of the treatments for gender dysphoria. Others include voice therapy and psychological support. The decision to have hormone therapy will be taken after a discussion between you and your clinic team.
In general, people wanting masculinisation usually take testosterone and people after feminisation usually take oestrogen.
Both usually have the additional effect of suppressing the release of “unwanted” hormones from the testes or ovaries.
Whatever hormone therapy is used, it can take several months for hormone therapy to be effective, which can be frustrating.
It’s also important to remember what it cannot change, such as your height or how wide or narrow your shoulders are.
The effectiveness of hormone therapy is also limited by factors unique to the individual that cannot be overcome simply by adjusting the dose.
Low Estrogen Can Affect You At Any Age
Low estrogen levels can leave you feeling poorly. Yet, before you are diagnosed, the confusion about why youre suffering can be worse than dealing with your symptoms. Signs of low estrogen are often very similar to those of menopause. However, what many dont realize is that you can be affected by low estrogen well before you enter perimenopause. Even women in their 20s and 30s may require hormone replacement therapy for many different reasons. If you suspect that you may have low estrogen levels, its important to see a doctor. A womens health care provider can test your hormone levels and determine the best course of action to help you feel better.
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Where Does Evidence About The Health Effects Of Mht Come From
The most comprehensive evidence about the health effects of MHT comes from two randomized clinical trials that were sponsored by the National Institutes of Health as part of the Womens Health Initiative :
- The WHIEstrogen-plus-Progestin Study, in which women with a uterus were randomly assigned to receive either a hormone pill containing both estrogen and progestin or a placebo. The median duration of treatment was 5.6 years.
- The WHI Estrogen-Alone Study, in which women without a uterus were randomly assigned to receive either a hormone pill containing estrogen alone or a placebo. The median duration of treatment was 7.2 years.
More than 27,000 healthy women who were 50 to 79 years of age at the time of enrollment took part in the WHI hormone therapy trials. The goals of these trials were to see if MHT prevents heart disease and bone fractures in postmenopausal women and to determine if MHT affects risks of breast cancer and, for women with a uterus, endometrial cancer. Both trials were stopped early , when it was determined that both types of therapy were associated with specific health risks, but long-term follow up of the participants continues to provide new information about the health effects of MHT.
What Is The Average Age For Treatment
The average age of hormone therapy patients differs depending on their specific symptoms and medical needs, but most specialists recommend treatments for women between the ages of 47 and 55 to effectively address common symptoms of menopause including hot flashes, fatigue, and hormonal weight gain.
Some doctors may also advise that therapy be started even earlier to increase the benefits, while also reducing the limited risks involved.
Reduce Hot Flashes And Night Sweats
Low levels of estrogen in your body can cause hot flashes, a sudden intense flushed feeling accompanied by sweating, dizziness, nausea or weakness. These can occur during the day or night and disturb quality of sleep. Increased fatigue contributes to feelings of irritability and mood swings. According to a study published in the June 2010 issue of Menopause International, hormone replacement therapy is an effective treatment for hot flushes in 80 percent of cases 2. Non-hormonal treatments are available, but they do not provide the same degree of relief that estrogen does. Fears concerning elevated cancer risks associated with HRT, and the fact that not enough is known about the exact causes of hot flushes, limits development of additional alternative treatments.
- Low levels of estrogen in your body can cause hot flashes, a sudden intense flushed feeling accompanied by sweating, dizziness, nausea or weakness.
- Fears concerning elevated cancer risks associated with HRT, and the fact that not enough is known about the exact causes of hot flushes, limits development of additional alternative treatments.
How Do I Transition Off Of Bioidentical Hormones
2. How do I transition off them if Im already taking them? Some women who start taking bioidentical hormones get to a point where theyd like to wean themselves off or reduce their dose and perhaps start taking more natural remedies instead.
I am 67 years old and have been using bioidentical hormone drops as prescribed by your former colleague Dr. Hargrove for about 15 years. At age 47 I experienced chemo induced menopause from treatment for non Hodgkins lymphoma.
Please leave your comments below. Christiane Northrup, M.D., is a visionary pioneer and a leading authority in the field of womens health and wellness. Recognizing the unity of body, mind, and spirit, she empowers women to trust their inner wisdom, their connection with Source, and their ability to truly flourish.
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What Is Menopausal Hormone Therapy
Menopausal hormone therapy also called postmenopausal hormone therapy and hormone replacement therapyis a treatment that doctors may recommend to relieve common symptoms of menopause and to address long-term biological changes, such as bone loss, that result from declining levels of the natural hormonesestrogen and progesterone in a womans body during and after menopause.
MHT usually involves treatment with estrogen alone or estrogen plus progestin, a synthetic hormone whose effects are similar to those of progesterone.
Women who have a uterusthat is, who have not had a hysterectomyare generally prescribed estrogen plus progestin for MHT. This is because estrogen alone is associated with an increased risk of endometrial cancer, but estrogen plus progestin is not. Estrogen is used alone only in women who have had a hysterectomy.
The Role Of Estrogen In Your Body
In its role as the major sex hormone in your body, estrogen does some pretty important things that aren’t related to fertility. As a hormone, estrogen acts on the parts of your body that have estrogen-specific hormone receptors. Estrogen is involved with numerous important functions throughout your body.
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Why Do I Need To Be Monitored
Monitoring your health will help your doctor to ensure that your body is absorbing the medication. It can also help your doctor to identify any health problems early so that, if necessary, your hormone treatment can be adjusted and/or additional medication may be prescribed.
It is very important that you give full details to your doctor of any history you and/or your family have of breast cancer or circulatory or liver disorders. This does not mean that you cannot have hormone therapy, but your doctor will be able to advise you on the available treatment options, and the follow-up monitoring, to suit your particular needs.
A healthy lifestyle is important. You should eat sensibly and take regular exercise. Drug taking, excessive alcohol consumption and obesity are all factors that can undermine your hormone treatment and heighten the risk of complications, which may affect your chances of having surgery. Smoking, in particular, is a significantly greater risk to you than hormone treatment. In addition, if you are a trans woman and you are taking oestrogen, smoking reduces its feminising effects.
It is important for you to understand that e with regular monitoring, you may still experience adverse side effects. If, at any time, you experience chest pain or breathlessness, discomfort in the calf or unusually frequent and/or severe headaches, you should seek urgent medical help.
Will I need to stop taking hormones before surgery?
Medication to reduce testosterone effects:
The Way We’re Raising Transgender Children Has To Change According To New Guidelines From Researchers At The Royal Children’s Hospital Melbourne And The Murdoch Children’s Research Institute
The report is a comprehensive summary for Australian practitioners who work with transgender and gender diverse young people. It rejects both the need for a standardised legal age of consent and the long-term puberty suppression that adolescents are often subjected to.
One of the authors of the guidelines, paediatrician and head of the Department of Adolescent Medicine at RCH Dr Michelle Telfer, told Buzzfeed News that gender-affirming care during childhood and adolescence is the only way to improve mental health outcomes, and decrease rates of depression, anxiety, self-harm and suicide, in this vulnerable population
“We’ve seen 1,000 young people come through the Royal Children’s Hospital over the past 14 years we see absolutely before our eyes the improvement when these young people are empowered to be who they are,” Dr Telfer said.
Dr Michelle Telfer
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What Should You Do In Your 70s For Health
Just stay active and cut calories if needed, says Alice Lichtenstein, D.Sc., director of the Cardiovascular Nutrition Laboratory at the USDA Human Nutrition Research Center on Aging. The Not-So-Good News: In your 70s you may secrete less hydrochloric acid, which decreases the availability of vitamin B12, says Lichtenstein.
Less Common Types Of Hormone Therapy
Some other types of hormone therapy that were used more often in the past, but are rarely given now include:
- Megestrol acetate , a progesterone-like drug
- High doses of estrogen
These might be options if other forms of hormone therapy are no longer working, but they can often cause side effects.
Why Does Your Estrogen Level Matter
Estrogen is a hormone. Although present in the body in small amounts, hormones have big roles in maintaining your health.
Estrogen is commonly associated with the female body. Men also produce estrogen, but women produce it in higher levels.
The hormone estrogen:
- is responsible for the sexual development of girls when they reach puberty
- controls the growth of the uterine lining during the menstrual cycle and at the beginning of a pregnancy
- causes breast changes in teenagers and women who are pregnant
- is involved in bone and cholesterol metabolism
- regulates food intake, body weight, glucose metabolism, and insulin sensitivity
Girls who havent reached puberty and women approaching menopause are most likely to experience low estrogen. Still, women of all ages can develop low estrogen.
Common symptoms of low estrogen include:
How Is Low Estrogen Treated
Women who have low levels of estrogen may benefit from hormonal treatment. Hormonal treatment is the standard for low estrogen. There are non-hormonal options to help relieve symptoms. Non-hormonal options are preferred for women at high risk for breast cancer, blood clots, stroke, or liver disease.
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Putting A Pause On Puberty
When someone makes the decision to transition, part of that process can be social choosing a new name, changing pronouns, wearing different clothes and part of it can be medical.
One of the more recent medical developments is the use of puberty blockers to treat children who are transgender or gender non-conforming. The medications, which suppress the bodys production of estrogen or testosterone, essentially pause the changes that would occur during puberty.
Thats really what these pubertal blockers do, Dr. Rob Garofalo told FRONTLINE. Garofalo is the director of the Lurie Childrens Hospitals Gender and Sex Development Program. They allow these families the opportunity to hit a pause button, to prevent natal puberty until we know that thats either the right or the wrong direction for their particular child.
Doctors who use puberty blockers say they allow children who experience gender dysphoria the feeling that theyre in the wrong body the time and space to explore and settle on their gender identity. What makes treatment tricky is that there is no test that can tell whether a child experiencing distress about their gender will grow up to be transgender. The handful of studies that do exist suggest that gender dysphoria persists in a minority of children, but they involved very few children and were done mostly abroad.
Another area where doctors say there isnt enough research is the impact that suppressing puberty has on brain development.
The Guidelines Reject Aspects Of The World Professional Association For Transgender Health Standards Of Care Which Are Conventionally Upheld As A Global Authority On Treatment Of Trans And Gender Diverse Young People
The new guidelines reject a standardised age of informed consent for hormonal treatment, as the authors assert that adolescents vary in the age at which they become competent to make those decisions.
However the WPATH Standards of Care Version 7, published in 2011, states that stage 2 hormone therapy should only be provided to those who are able to legally consent to the treatment, and this sets the minimum age of consent at 16 years old.
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S For Taking Estrogen
Estrogen can be taken in a number of different ways. People receive estrogen through a pill, injection, patch, or even a topical cream. It’s not just a matter of preference. The route by which people take estrogen affects some of the risks of estrogen treatmentestrogen is absorbed by the body differently depending on how you take it.
Much of the research on the risks of estrogen treatment focus on oral estrogensthose taken by mouth. What research has found is that oral estrogen seems to cause an increased risk of a number of problematic side effects when compared to topical or injected estrogens. This is because of the effects of ingested estrogen on the liver when it passes through that organ during the process of digestion.
This is referred to as the hepatic first pass effect and it is not an issue for estrogen treatment that isn’t taken in pill form. The hepatic first pass effect causes changes in a number of physiological markers that affect cardiovascular health.
These changes may lead to an increase in blood clotting and reduced cardiovascular health. They are not seen as often, if at all, with non-oral estrogens. Therefore, non-oral estrogens may be a safer option.
One Of The Most Confusing Questions A Woman Faces Is Whether Or Not To Take Hormones I Encourage You To Educate Yourself About All The Options So You Can Work In Partnership With Your Doctor To Make The Decision Thats Right For You Gone Are The Days When A Woman Would Go To Her Physician And Then Docilely Fill The Prescription She Is Given Without Trying To Understand How The Medication Will Affect Her Body And Thats Great Especially When It Comes To Supporting Your Fluctuating Hormone Levels
One of the most confusing questions a woman faces is whether or not to take hormones. I encourage you to educate yourself about all the options, so you can work in partnership with your doctor to make the decision thats right for you. Gone are the days when a woman would go to her physician and then docilely fill the prescription she is given without trying to understand how the medication will affect her body. And thats great, especially when it comes to supporting your fluctuating hormone levels!
A one-size-fits-all approach to medicine is never good medicine every woman is different. This is true of hormone therapy , too. While there are norms, and low levels of estrogen, progesterone, and testosterone will cause similar symptoms in all women, the solution that works for you can be as unique as you are. Some women need hormone therapy, while others will get tremendous relief with herbs, changes in diet , supplementation, and/or adding exercise.
Even if you are someone who needs hormone therapy, rest assured hormone therapy isnt a life sentence. Menopause is not a medical condition that requires medication, especially not for life. Starting hormone therapy doesnt mean youre stuck with it forever. And what you start with may or may not be the right thing for you in the future. Its fine to adjust your dosage along the way. Many women reevaluate their HT annually, and taper off if they no longer need it.