Trials of the 'tranopause'.

There are similarities to be drawn between transgender people accessing gender-affirming hormone therapy (GAHT) and cis women accessing menopause management, with hormone replacement therapy (HRT). For both, it’s a journey, with potential hurdles and difficulties including significant problems in accessing service provision, but the difficulties are much more extreme for trans people. One in four trans people self-medicate and 50% will use private clinics to expedite initiation of GAHT. Trans people face challenges relating to fear, ignorance and bias, with many clinicians refusing to prescribe hormone therapy for them because they have no knowledge of the subject area. In this Tales from the clinic, we focus on the trials of the ‘tranopause’ and highlight the importance of listening to the patient and providing holistic care for people transitioning from the gender they were assigned at birth. There are potential opportunities for collaboration between primary care, secondary care including psychiatric services and sexual health to improve understanding and care for trans people; all of whom need to be listened to, to identify where on the pyramid below, their needs are positioned and to minimise problems with physical and mental health.