Transgender Healthcare Demands Multispecialty Care

Bruce Jenner's Story Sparks Interest in Gender Issues

Wylie Hembree, MD; Christine Wiebe

Disclosures

May 08, 2015

In This Article

What Does It Mean to Be "Transgender"?

Editor's Note: Bruce Jenner's recent declaration that he thinks of himself as a woman was puzzling for many people, whether they formerly knew him as an Olympic athlete or as the father on a reality TV show. But for clinicians who routinely treat transgender patients, his story was not that unusual.

The underlying issues of being transgender are much better understood by clinicians today than a few decades ago, but that understanding continues to evolve. Medscape recently discussed those issues with Wylie Hembree, MD, who helped write the first clinical practice guidelines on transgender treatment, issued by the Endocrine Society in 2009.[1] He has been treating transgender patients for more than 20 years.

Medscape: In the guidelines, you recommend that the first place a person with gender dysphoria start is with a mental health professional. Is that right?

Dr Hembree: Yes. I have to laugh, because I was the chair of the committee then that wrote it and am again the chair of the committee revising it. The question that you hit upon is indeed something that is controversial among the nine committee members. It was not controversial in 2007 when we started working on it before. So I can't really give you a straightforward answer on that. You are correct that we said, with great clarity, that we felt at that point that the diagnosis is usually made by a mental health professional.

Now there have been changes—even in the coding—and we'll actually change some of the terms. This time, we will use the word "transgender" as opposed to "transsexual," because "transgender" has evolved into a broader term, and we are now using "gender dysphoria" as opposed to "gender identity disorder."

The individual who has gender dysphoria and wants to do everything possible to live in the opposite gender is today referred to as being transsexual—not only taking hormones but also having available surgery.

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