Establishing a Transgender Outpatient Clinic Within the Gynaecology Department: a Retrospective Analysis of the First Few Years.

Abstract

Introduction: Despite an increasing proportion of transgender individuals within the general population, robust epidemiological data on the medical care of transgender people in Germany remain limited. Data derived from a specialized transgender outpatient clinic provide insights into patient characteristics, diagnostic pathways, and treatment trajectories, and offer a basis for further development of needs-based, patient-centered care.

Methods: This cross-sectional study includes retrospectively collected data from 199 transgender individuals who presented between 2020 and 2025 at the gynaecological endocrinology outpatient clinic of the University Hospital Dresden with a diagnosis or suspicion of gender incongruence (according to ICD-11).

Results: The number of initial consultations increased continuously from 2020 to 2025. The majority of patients were young adults; initially, transfeminine individuals predominated, whereas in 2025, more transmasculine individuals presented. Gender-affirming hormone therapy was initiated (n = 111) or continued (n = 68) in 179 individuals. Fertility preservation measures prior to the initiation of hormone therapy were infrequently utilized. The median interval between first awareness of gender dysphoria and uptake of medical interventions was 11 years. Psychiatric comorbidities were reported by 53% of individuals, more frequently among trans women than trans men (trans women 60% vs. trans men 43%, p = 0.016).

Conclusion: This study demonstrates the increasing demand for transgender-specific healthcare services. Transgender medicine should be more firmly integrated into standard care, with initiation of hormone therapy in specialized centres and continuation of treatment in outpatient settings appearing to be an appropriate model. A prospective, multicentre registry study is warranted to assess long-term outcomes. Currently, evidence in Germany is still largely based on retrospective and single-centre data. The present study confirms an increased prevalence of psychiatric comorbidities, underscoring the importance of structured psychological and/or psychiatric co-management as an integral component of interdisciplinary transgender care.