While there is anecdotal evidence of cases where a child firmly identified as another sex from a very early age, studies cited in the standards of care show that in the majority of cases such identification in childhood does not persist into adulthood. Rupert Lanzenberger, show that administration of the male hormone testosterone in female-to-male transsexuals raises brain levels of SERT, the protein that transports the chemical messenger serotonin into nerve cells. Two non-homosexual male-to-female transsexuals expressed regrets. Lanzenberger added, "These results may explain why testosterone improves symptoms in some forms of depression. This treatment is controversial as the use of puberty blockers involves a small risk of adverse physical effects. Binding of the chest tissue can cause a variety of health issues including reduced lung capacity and even broken ribs if improper techniques or materials are used. It is always advised that all changes in therapeutic hormonal treatment should be supervised by a physician because starting, stopping or even changing dosage rates and levels can have physical and psychological health risks.
HRT may, however, reverse some characteristics, such as distribution of body fat and muscle, as well as menstruation in trans men. In adolescents, careful diagnosis and following strict criteria can ensure good post-operative outcomes. Binding of the chest tissue can cause a variety of health issues including reduced lung capacity and even broken ribs if improper techniques or materials are used. SERT plays an important role in the treatment of mood and anxiety disorders. Anatomic results of neophallus surgical procedures are often less satisfactory in terms of function and appearance than neovaginal procedures for trans women. Two non-homosexual male-to-female transsexuals expressed regrets. For example, it would be extremely problematic to include a 'long-term placebo treated control group' in an RCT of hormone therapy efficacy among gender variant adults desiring to use hormonal treatments. A mastectomy is performed, often including a nipple graft for those with a B or larger cup size. This is especially common amongst surgeons who practice in Asia. Improvements in psychological functioning were positively correlated with postsurgical subjective well-being. As Medicaid and private insurers often take their cues from Medicare on what to cover, this may lead to coverage of sex reassignment therapy by Medicaid and private insurers. In addition, some genetics studies have suggested that higher levels of serotonin transporter may increase resilience to stress and reduce risk for stress and mood disorders. Her paper was allegedly instrumental in removing Medicaid and Medicare support for sex reassignment therapy in the US. As of February , the most recent version of the standards is Version 7. The authors noted that the results suggested that those who received sex reassignment surgery before had worse mortality, suicidality, and crime rates than those who received surgery on or after In many areas with comprehensive nationalized health care, such as some Canadian provinces and most European countries, SRT is covered under these plans. Notably, the Roman Catholic church, according to an unpublished Vatican document, holds that changing sex is not possible and, while in some cases treatment might be necessary, it does not change the person's sex in the eyes of the church. This treatment is controversial as the use of puberty blockers involves a small risk of adverse physical effects. In contrast, male-to-female transsexuals who received a testosterone blocker and the female hormone estrogen showed decreased levels of this protein in the brain. Also, some patients who are not happy with their reassignment may be more known to clinicians as they continue clinical contact. HHS says it will move to implement the ruling. Because women are twice as likely to be diagnosed with depression as men, these changes in the levels of SERT are consistent with the increased risk for mood and anxiety disorders in females relative to males. The vast majority functioned quite well psychologically, socially and sexually. According to his own article,  when he joined Johns Hopkins University as director of the Department of Psychiatry and Behavioral Science, it was part of his intention to end sex reassignment surgery there. Often, at least a certain period of psychological counseling is required before initiating hormone replacement therapy, as is a period of living in the desired gender role, if possible, to ensure that they can psychologically function in that life-role.
Video about chemical sex change:
Hormones and Gender Transition
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