Introduction: Gender incongruence is an individual's dissatisfaction with their assigned gender and their identification with a gender other than that associated with their birth sex, based on physical sex characteristics, and given by their genitalia at birth; "dysphoria" refers to the psychological distress and discomfort experienced; only some people with gender incongruence experience gender dysphoria at some point in their lives. Gender incongruence is a condition, which should not be evaluated as inherently pathological or negative.
Objective: Generate recommendations from expert consensus on terminology, diagnostic criteria for gender incongruence/gender dysphoria, comprehensive management of comorbidities in gender incongruence/gender dysphoria, Defining the management and therapeutic goals of affirmative hormone therapy in those over 18 years old, defining the criteria for performing gender affirmation surgery, defining the medical monitoring in patients over 18 years of age with gender incongruence/dysphoria, defining the criteria for the use of puberty blockers, defining the criteria and recommendations for the initiation of cross-sex hormone therapy, and defining the management algorithm for approaching the newborn with atypical genitalia-certain sex assignment.
Materials and methods: A modified Delphi type consensus was carried out with the participation of 10 clinical specialists (endocrinologists, pediatric endocrinologists, aesthetic and reconstructive plastic surgeons, urologists, and psychiatrists), as well as a development group. Based on the analysis of the results, recommendations were presented.
Results: Recommendations were defined for: terminology, diagnostic criteria on gender incongruence/gender dysphoria, comprehensive management of comorbidities in gender incongruence/gender dysphoria, management and therapeutic goals of hormone affirmative therapy in over 18s, criteria for performing gender affirming surgery, medical monitoring in patients over 18 years old with gender incongruence/dysphoria, criteria for the use of puberty blockers, criteria and recommendations for initiation of cross-sex hormone therapy, and a management algorithm for approaching the newborn with atypical genitalia-certain sex assignment.
Conclusions: Gender incongruence and gender dysphoria are words with similarity, but not synonymous. However, their diagnostic criteria, affirmative hormonal treatments, gender affirming surgeries and medical monitoring are the same.
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