{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T04:29:57Z","timestamp":1782534597392,"version":"3.54.5"},"reference-count":26,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2019,2,12]],"date-time":"2019-02-12T00:00:00Z","timestamp":1549929600000},"content-version":"vor","delay-in-days":11,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100012128","name":"Austin Medical Research Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100012128","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["1143333"],"award-info":[{"award-number":["1143333"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001114","name":"The Endocrine Society of Australia","doi-asserted-by":"publisher","award":["Postdoctoral Award"],"award-info":[{"award-number":["Postdoctoral Award"]}],"id":[{"id":"10.13039\/501100001114","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Internal Medicine Journal"],"published-print":{"date-parts":[[2019,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Despite increasing demand for transgender healthcare, guidelines for cross\u2010sex hormone therapy are based on low\u2010level evidence only. As most data are based on international expert opinions, interpretations and practices vary significantly.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To aid the development of Australian clinical guidelines, we aimed to identify cross\u2010sex hormone therapy prescribing patterns among medical practitioners experienced in adult transgender healthcare.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted an anonymous online survey of experienced hormone prescribers who were members of the Australian and New Zealand Professional Association for Transgender Health (ANZPATH).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We received 35 responses from 43 individuals listed with ANZPATH. Mental health assessments prior to commencement of hormonal therapy were recommended by 80% of prescribers. The preferred first\u2010line masculinising hormone therapy was intramuscular testosterone undecanoate (46% of respondents). The most commonly prescribed feminising agents were oral estradiol valerate (first line in 71.4%), with either spironolactone or cyproterone acetate. Most respondents (&gt;90%) targeted sex steroid reference ranges of the affirmed gender, and 71.4% reviewed individuals every 2\u20133 months in the first year. Better training for doctors was seen as the most pressing priority for government funding, and 79.3% supported the development of local Australian\u2010based guidelines.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Experienced hormone prescribers in Australia largely use medication regimens and monitor sex steroid levels and potential adverse effects of sex hormone therapy in accordance with broad, subjective recommendations listed in international guidelines. Additional practitioner training is necessary, and local Australian\u2010based guidelines would offer specific, relevant guidance to clinicians in the initiation and monitoring of cross\u2010sex hormone therapy for adult transgender individuals.<\/jats:p><\/jats:sec>","DOI":"10.1111\/imj.14035","type":"journal-article","created":{"date-parts":[[2018,7,11]],"date-time":"2018-07-11T02:37:05Z","timestamp":1531276625000},"page":"182-188","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Cross\u2010sex hormone therapy in Australia: the prescription patterns of clinicians experienced in adult transgender healthcare"],"prefix":"10.1111","volume":"49","author":[{"given":"Ingrid","family":"Bretherton","sequence":"first","affiliation":[{"name":"Department of Medicine (Austin Health) The University of Melbourne  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Thrower","sequence":"additional","affiliation":[{"name":"Department of Medicine (Austin Health) The University of Melbourne  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathis","family":"Grossmann","sequence":"additional","affiliation":[{"name":"Department of Medicine (Austin Health) The University of Melbourne  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey D.","family":"Zajac","sequence":"additional","affiliation":[{"name":"Department of Medicine (Austin Health) The University of Melbourne  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5257-5525","authenticated-orcid":false,"given":"Ada S.","family":"Cheung","sequence":"additional","affiliation":[{"name":"Department of Medicine (Austin Health) The University of Melbourne  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,2,12]]},"reference":[{"key":"e_1_2_6_2_1","unstructured":"StraussP CookA WinterS WatsonV Wright ToussaintD LinA. Trans Pathways: the mental health experiences and care pathways of trans young people. Summary of results. Perth: Telethon Kids Institute;2017."},{"key":"e_1_2_6_3_1","unstructured":"HydeZ DohertyM TilleyPJM McCaulKA RooneyR JanceyJ.The First Australian National Trans Mental Health Study: Summary of Results. School of Public Health. Perth: Curtin University;2014."},{"key":"e_1_2_6_4_1","unstructured":"SmithE JonesT WardR DixonJ MitchellA HillierL. From blues to rainbows: mental health and wellbeing of gender diverse and transgender young people in Australia. Melbourne: The Australian Research Centre in Sex Health and Society La Trobe University;2014."},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-015-1867-2"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291717003853"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.2009.03625.x"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-10-1038"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1080\/15532739.2011.700873"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2017-01658"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/journalofethics.2016.18.11.sect1-1611"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/andr.12485"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/andr.12382"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2017-01643"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2017-01559"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2265.1997.2601068.x"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1210\/js.2017-00465"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1210\/en.2017-00884"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajpendo.00161.2017"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2017-01642"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1161\/ATVBAHA.109.196022"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(03)14066-4"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.c2519"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.24593"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOH.0b013e32833c07bc"},{"key":"e_1_2_6_26_1","first-page":"CD002229","article-title":"Hormone therapy for preventing cardiovascular disease in post\u2010menopausal women","author":"Boardman HM","year":"2015","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2011.1255"}],"container-title":["Internal Medicine Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fimj.14035","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/imj.14035","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,14]],"date-time":"2023-09-14T23:28:08Z","timestamp":1694734088000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/imj.14035"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,2]]},"references-count":26,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2019,2]]}},"alternative-id":["10.1111\/imj.14035"],"URL":"https:\/\/doi.org\/10.1111\/imj.14035","archive":["Portico"],"relation":{},"ISSN":["1444-0903","1445-5994"],"issn-type":[{"value":"1444-0903","type":"print"},{"value":"1445-5994","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,2]]},"assertion":[{"value":"2018-05-07","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-07-02","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-02-12","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}