The 4th edition of Sherbourne Health’s Guidelines for gender-affirming primary care with trans and non-binary patients (formerly the Guidelines and protocols for hormone therapy and primary health care for trans clients) is now available for download on the website of Sherbourne’s Rainbow Health Ontario (RHO) program.

Says Sherbourne Health President & CEO Hazelle Palmer, “We couldn’t be prouder to continue to share Sherbourne’s clinical expertise in caring for trans and non-binary clients with the broader medical community as part of our commitment to gender-affirming care.”

This edition, like its predecessor, was authored by Dr. Amy Bourns, a family physician on Sherbourne’s LGBT2SQ Health Team. In addition to incorporating recently available evidence in both general primary care and trans health, the 2019 edition features revisions and expansions in several areas, including:

  • expanded discussion of considerations for non-binary patients;
  • unique considerations for older trans patients;
  • incorporation of changes to the International Statistical Classification of Diseases and Related Health Problems (ICD) diagnosis;
  • subtle language changes that reflect the rapid pace of cultural change;
  • an expanded discussion of fertility considerations for trans people;
  • discussion of alternate routes of hormone administration;
  • expanded discussion of HIV prevention and treatment in transfeminine and transmasculine populations;
  • an updated monitoring schedule with a reduced number of routine bloodwork parameters required;
  • an overview of the role of PCPs in supporting patients with transition-related surgeries; and
  • a review of the updated process for referrals and public funding for transition-related surgeries in Ontario.

Hard copies of the Guidelines will soon be available to order in the RHO store. The Trans Primary Care Guide, the online interactive tool based on the Guidelines, is currently being updated to reflect the most current clinical information consistent with this new 4th edition of the Guidelines.


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