Transgender care: doctors are advised to return to “ordinary best practice”

Dear Editor,

This was an interesting, informative and well balanced conference. It was good to be reminded of the important first principles of giving every patient a thorough assessment and examination, and then using best evidence to make recommendations.

Several expert speakers showed that many young people with dysphoria have complex mental health problems and that the focus should be on treating these before embarking on life changing irreversible medical and/or surgical treatments. These initial therapies would be within the patients mental health teams.

More follow up studies are needed to assess the short and long term effects of medical and surgical interventions. More information is needed both in terms of physical effects and complications and in terms of psychological outcomes. The one patient speaker at the conference reported ongoing daily pain, and other difficult symptoms. It was moving to hear the testimony of someone still attending multiple hospital departments and clinics with problems years after surgery.