Department of Pharmacy Practice, Creighton University School of Pharmacy and Health Professions, Omaha, NE 68178, USA.
Pharmacotherapy. 2012 Jan;32(1):54-66. doi: 10.1002/PHAR.1006.
Gender identity disorder (GID), or transsexualism, is an increasingly recognized medical condition with an expanding body of medical literature to support the use of established therapeutic guidelines. Transsexualism can be effectively managed through exogenous cross-sex hormone administration used to induce development of desired sex characteristics, as well as use of other agents, such as aldosterone antagonists, aimed at decreasing physical characteristics of the undesired sex. Many complications can arise with the use of the available therapies, and these must be considered before determining the appropriate course of action. This review describes methods, including both pharmacotherapy and surgical interventions, for effective medical management of both male and female adults with GID. In addition, specific goals of therapy as well as safety aspects with long-term use of pharmacotherapeutic agents are discussed. This review also discusses some special considerations for treating patients with significant, yet common, comorbid diseases such as human immunodeficiency virus infection, acquired immunodeficiency syndrome, and viral hepatitis, as these conditions may complicate the clinical course and preclude some patients from using certain therapies. Pharmacist involvement in the management of transsexualism can be extremely beneficial to patients and other health care providers. Pharmacists can help determine the appropriate therapy, optimize dosages, monitor for adverse effects, and educate patients on what to expect during their therapy. Pharmacists should become knowledgeable about guidelines and current literature on transsexualism, understand the monitoring parameters for safe and effective therapy, and establish themselves as partners in the collaborative management of this disorder.
性别认同障碍（GID）或易性癖，是一种日益被认可的医学病症，有大量医学文献支持既定治疗指南的应用。通过外源性跨性别激素治疗来诱导所需性特征的发育，以及使用其他药物，如醛固酮拮抗剂，来减少不需要的性别的身体特征，可以有效地管理易性癖。使用现有疗法会出现许多并发症，在确定适当的治疗方案之前，必须考虑这些并发症。这篇综述描述了有效管理男性和女性 GID 成年患者的方法，包括药物治疗和手术干预。此外，还讨论了治疗的具体目标以及长期使用药物治疗的安全性方面。本文还讨论了一些特殊考虑因素，用于治疗患有常见合并症的患者，如人类免疫缺陷病毒感染、获得性免疫缺陷综合征和病毒性肝炎，因为这些情况可能会使临床病程复杂化，并使某些患者无法使用某些治疗方法。药剂师参与易性癖的治疗对患者和其他医疗保健提供者非常有益。药剂师可以帮助确定适当的治疗方法、优化剂量、监测不良反应，并教育患者在治疗期间的预期情况。药剂师应该了解易性癖的指南和最新文献，了解安全有效的治疗监测参数，并将自己确立为合作管理这种疾病的伙伴。
