A 25-year-old transgender woman presents to your clinic requesting gender-affirming hormone therapy. She

A 25-year-old transgender woman presents to your clinic requesting gender-affirming hormone therapy. She reports experiencing gender dysphoria since early childhood, but has not yet socially transitioned or legally changed her name and gender marker. Which of the following is the most appropriate next step in her care? Select one: a. Recommend the patient live in her identified gender role for 12 months prior to starting hormone therapy, to ensure she is certain about her transition. b. Refer the patient to a mental health professional for a formal evaluation and diagnosis of gender dysphoria before prescribing hormones. с. Initiate estrogen therapy immediately, as the patient has clearly articulated her gender identity and desire for medical transition. d. Discuss the patient’s goals and concerns, obtain informed consent, and prescribe a low-dose estrogen regimen to start, with close monitoring.

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