Medical Practitioners

If you are a medical practitioner (GP) seeking information about supporting a transgender or gender diverse patient this page may assist you. The Primary Health Network of Western Melbourne has also created a transgender health GP Module that may help GP’s in this field of medicine. 

The following documents can help guide a GP when exploring aspects such as Hormone Replacement Therapy. This includes health assessment and pre-screening (inc blood tests), initiating hormone therapy and monitoring ongoing care:
HNE Assessment Guide for GPs
HNE Management Guidelines for GPs

These documents can help ensure people have a clearer understanding of hormone therapy and break down some myths:
Testosterone-FAQ – Equinox (Victoria)
Oestrogen-FAQ – Equinox (Victoria)

written by Thorne Harbour (formerly Victorian AIDS Council) for Equinox and endorsed by AusPATH and Monash Health (Gender Clinic).

Informed Consent Forms for medical practitioners prescribing HRT:
Informed Consent Oestrogen
Informed Consent Testosterone

All practitioners should carefully explore the risks and expectations of Hormone Replacement Therapy with a patient/client. Consider these extracts from the WPATH Standards of Care as a starting point for discussion:
Feminising Hormones Risks and Timelines WPATH
Masculinising Hormones Risks and Timelines WPATH

Aotearoa New Zealand also has an in depth document titled Guidelines for Gender Affirming Healthcare which utilizes informed consent models and practitioner information for initial assessment, prescribing, and ongoing care.
Guidelines for Gender Affirming Healthcare Aotearoa New Zealand

UNDER 18’s
The Australian Standards of Care and Treatment Guidelines: for trans and gender diverse children and adolescents (ASOCTG), aim to maximise quality care provision to transgender and gender diverse (TGD) children and adolescents across Australia, while recognising the unique circumstances of providing such care to this population.

Additional resource – Center of Excellence for Transgender Health (Uni of California – San Francisco)
An additional resource providing guidelines of care for gender affirming care of transgender and gender diverse persons. This is a very in-depth resource and highly regarded.

THSA reminds that these are tools for medical practitioners to provide patient informed care with the support of the practitioner. THSA does not endorse nor promote, in any way, self medication.

Testosterone Prescribing

Note – Primoteston injectable is no longer on PBS and can only be written on Private Prescription as on February 1st, 2018.

For trans masculine folk wishing to access hormone therapy, it can be a bit muggy knowing how to access anything but hopefully this clears it up. This is taken directly from the PBS federal guidelines under Medicare:

Of importance are the guidelines which are applicable for most (not all) trans masc:
 “Authority Required

  • Androgen deficiency  (THSA note – this is the most applicable to trans masc folk)

Clinical criteria:

  • Patient must have an established pituitary or testicular disorder.

Treatment criteria:

  • Must be treated by a specialist paediatric endocrinologist, specialist urologist, specialist endocrinologist or a Fellow of the Australasian Chapter of Sexual Health Medicine; or in consultation with one of these specialists; OR have an appointment to be assessed by one of these specialists.

The name of the specialist must be included in the authority application.”

This means a General Practitioner can prescribe once a referral has been written and an appointment made to a specialist as noted above.
THSA notes that in no way is this an endorsement not to access some health professionals and specialists. THSA values the work of practitioner specialists such as Endocrinologists and Sexual Health Physicians and encourages folk’ access the services they need in collaboration with their General Practitioner. This does however, empower GPs who feel capable and competent to be able to provide a service, to know they are able to do so without the need of a psychologist or psychiatrist if not deemed required for the indivudal.

Medication Prescribing for Transgender Women / Trans-Feminine Persons

Medications prescribed to those assigned male at birth (AMAB) do not have the same PBS and Medicare restrictions as testosterone. For example, androgen blockers such as Spironolactone or Cyproterone are considered  “General Schedule ” and do not have any “Authority” requirement as are medications containing estrogen/oestrodiol.

Trans Health SA acknowledges this means a suitably educated medical practitioner (GP) can prescribe these medications however it is highly encouraged to do so via a trained and experienced provider in trans and gender diverse health.