Endocrine Treatment of Gender-Dysphoric/ Gender-Incongruent Persons: An Endocrine Society Clinical Practice Guideline Educational Activity


Throughout recorded history (in absence of an endocrine disorder) some men and women have experienced confusion and anguish resulting from rigid, forced conformity to sexual dimorphism. The 20th century marked the emergence of a social awakening for more awareness, research and medical intervention for gender-incongruent persons.

Gender-affirmation is a multidisciplinary treatment in which endocrinologists play an important role. This update to the 2009 Endocrine Treatment of Transsexual Persons: An Endocrine Society Clinical Practice Guideline, updates the diagnostic classification, recommendations regarding children, surgery, monitoring and patient education.

Within this activity you will hear from the task force members regarding the latest recommendations and assess what you have learned in 5 short modules.

  • New Scientific Evidence 
  • Management of Transgender Children and Adolescents
  • Monitoring and Surveillance
  • Surgery and Follow-up Management
  • Guideline Summary

Introduction to Endocrine Treatment of Gender-Dysphoric/ Gender-Incongruent Persons: An Endocrine Society Clinical Practice Guideline by Wylie C. Hembree, MD


    This content is for physicians and healthcare professionals seeking to remain up to date on the latest recommendations made by the Society for endocrine treatment of Gender-Dysphoric/ Gender-Incongruent patients.


    By the end of this session, participants will be able to:

    1. List significant changes in the evidence base for Gender Dysphoria /Gender Incongruence since publication of the previous ES guideline on this topic.
    2. Define significant changes in best practices that are being recommended in the 2017 Gender Dysphoria/Gender Incongruence guideline due to changes in science.
    3. Identify gaps in the existing evidence base for Gender Dysphoria /Gender Incongruence which contribute to controversy or disagreement among clinicians about standards for optimal patient care.

      Additional Information

      Target Audience: 
      Clinical researcher
      Scientific researcher
      Nurse/Nurse practitioner
      Physician assistant
      Allied health professional
      Competency Area: 
      Patient Care and Procedural Skills
      Medical Knowledge
      Interpersonal and Communication Skills
      Topic Area: 
      Quality Improvement and Healthcare Delivery
      General Endocrinology
      Hormone Abuse
      Men’s Health
      Pediatric Endocrinology
      Women’s Health
      Level of Outcomes: 
      Level 1 (Participation)
      Level 2 (Satisfaction)
      Level 3A (Learning: Declarative Knowledge (Knows))
      Level 3B (Learning: Procedural Knowledge (Knows How))
      Activity summary
      Available credit: 
      • 1.00 ABIM MOC
      • 1.00 ABP MOC
      • 1.00 AMA PRA Category 1 Credits
      • 1.00 CME Certificate of Participation
      Course opens: 
      Course expires: 

      Wylie C. Hembree, MD

      Associate Attending Physician
      New York Presbyterian Hospital
      Endocrinology, Diabetes & Metabolism

      Peggy T. Cohen-Kettenis, PhD
      Professor Emeritus
      Department of Medical Psychology
      VU University Medical Center, Amsterdam

      Stephen M. Rosenthal, MD
      Professor of Pediatrics
      Division of Pediatric Endocrinology
      Medical Director, Child and Adolescent Gender Center
      Benioff Children's Hospital
      University of California San Francisco

      Joshua D. Safer, MD
      Associate Professor of Medicine and Molecular Medicine
      Boston University School of Medicine
      Center for Endocrinology, Diabetes, Nutrition & Weight Management

      Vin Tangpricha, MD, PhD
      Associate Professor of Medicine
      Director of Fellowship Program
      Emory University School of Medicine


      As a provider of CME accredited by the Accreditation Council for Continuing Medical Education, the Endocrine Society has a policy of ensuring that the content and quality of this educational activity are balanced, independent, objective, and scientifically rigorous. The scientific content of this activity was developed under the supervision of the Endocrine Society’s guideline task force.


      The faculty, committee members, and staff who are in position to control the content of this activity are required to disclose to the Endocrine Society and to learners any relevant financial relationship(s) of the individual or spouse/partner that have occurred within the last 12 months with any commercial interest(s) whose products or services are related to the content. Financial relationships are defined by remuneration in any amount from the commercial interest(s) in the form of grants; research support; consulting fees; salary; ownership interest (e.g., stocks, stock options, or ownership interest excluding diversified mutual funds); honoraria or other payments for participation in speakers' bureaus, advisory boards, or boards of directors; or other financial benefits. The intent of this disclosure is not to prevent planners with relevant financial relationships from planning or delivery of content, but rather to provide learners with information that allows them to make their own judgments of whether these financial relationships may have influenced the educational activity with regard to exposition or conclusion. The Endocrine Society has reviewed all disclosures and resolved or managed all identified conflicts of interest, as applicable.

      The following GD/GI Task Force members reported relevant financial relationships:

      Stephen M. Rosenthal, MD: Advisory Board, AbbVie

      Vin Tangpricha, MD, PhD: Grantee, Cystic Fibrosis Foundation, National Institutes of Health

      The following GD/GI Task Force members reported no relevant financial relationships:

      Wylie C. Hembree, MD; Peggy T. Cohen-Kettenis, PhD; Joshua D. Safer, MD

      Disclosure information for presenters is included in their individual recorded presentations.

      Endocrine Society staff associated with the development of content for this activity reported no relevant financial relationships.



      The educational content in this activity relates to basic principles of diagnosis and therapy and does not substitute for individual patient assessment based on the health care provider’s examination of the patient and consideration of laboratory data and other factors unique to the patient. Standards in medicine change as new data become available.


      When prescribing medications, the physician is advised to check the product information sheet accompanying each drug to verify conditions of use and to identify any changes in drug dosage schedule or contraindications.


      The Endocrine Society has determined that disclosure of unlabeled/off-label or investigational use of commercial product(s) is informative for audiences and therefore requires this information to be disclosed to the learners at the beginning of the presentation. Uses of specific therapeutic agents, devices, and other products discussed in this educational activity may not be the same as those indicated in product labeling approved by the Food and Drug Administration (FDA). The Endocrine Society requires that any discussions of such “off-label” use be based on scientific research that conforms to generally accepted standards of experimental design, data collection, and data analysis. Before recommending or prescribing any therapeutic agent or device, learners should review the complete prescribing information, including indications, contraindications, warnings, precautions, and adverse events.


      The Endocrine Society will record learner’s personal information as provided on CME evaluations to allow for issuance and tracking of CME certificates. The Endocrine Society may also track aggregate responses to questions in activities and evaluations and use these data to inform the ongoing evaluation and improvement of its CME program. No individual performance data or any other personal information collected from evaluations will be shared with third parties.


      This activity is not supported by educational grant(s) or other funds from any commercial supporter.

      Accreditation Statement

      The Endocrine Society is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The Endocrine Society has achieved Accreditation with Commendation.

      The Endocrine Society designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credits. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

      Maintenance of Certification

      Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.0 MOC points in the American Board of Internal Medicine’s (ABIM) and American Board of Pediatric's Maintenance of Certification (MOC) program. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM and ABP MOC credit.

      Available Credit

      • 1.00 ABIM MOC
      • 1.00 ABP MOC
      • 1.00 AMA PRA Category 1 Credits
      • 1.00 CME Certificate of Participation

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