Once gender re-assignment has been completed, a maintainence dose may be needed. In spite of the difficulties encountered in the prescription of sex steroids, the transsexual's drive for re-assignment may lead him or her to procure and use these drugs without supervision. But after re-assignment, patient's may move area or change practices, often losing contact with the gender identity clinic. Pharmacological therapy involves suppression of the characteristics of the original gender and enhancement of characteristics of the adopted gender. Monitoring of response relies heavily on the patient's impressions.
Objective measures are less helpful.
Measurement of relevant hormone levels and other blood tests may forewarn of adverse effects of treatment. Transdermal patches for male and female gender re-assignment. Recent research of gynaecological endocrinology. Effects of oestrogens on prolactin secretion in transsexual subjects. Freidl KE, Reappraisal of the health risks associated with the use of high doses of oral and injectable androgenic steroids.