Eligibility Criteria The administration of hormones is not to be lightly undertaken because of their medical and social dangers. Three criteria exist.

1. age 18 years

2. demonstrable knowledge of what hormones medically can and cannot do and their social benefits and risks;

3. Either a documented real life experience should be undertaken for at least three months prior to the administration of hormones Or

4. A period of psychotherapy of a duration specified by the mental health professional after the initial evaluation (usually a minimum of three months) should be undertaken

5. Under no circumstances should a person be provided hormones who has neither fulfilled criteria #3 or #4.

Readiness Criteria. Three criteria exist:

1. the patient has had further consolidation of gender identity during the real-life experience or psychotherapy;

2. the patient has made some progress in mastering other identified problems leading to improving or continuing stable mental health (this implies an absence of problems such as sociopathy, substance abuse, psychosis, suicidality, for instance);

3. hormones are likely to be taken in a responsible manner.

Can Hormones Be Given For Those Who Do Not Initially Want Surgery or a Real Life Experience? Yes, but after diagnosis and psychotherapy with a qualified mental health professional following minimal standards listed above. These cases often are deeply controversial and require particular caution.