Reference no: EM133711965

Question

A 21-year-old college graduate assigned male at birth presents with the desire to transition to the female gender. Eight months ago, she was started on hormone therapy (oral pills daily and twice-weekly patches). The patient is asking about the removal of male genitalia and vagina formation. In addition, the patient is concerned about her prominent "Adam's apple" and deepness of voice. She wears gender-neutral clothing and has a somewhat masculine haircut. She usually presents as a male to work and female at home, and occasionally when she goes out at night. Her friends and family are supportive of her desire to change. She smokes one pack of cigarettes per day and drinks two beers daily. She has no children. She is happy with the physical changes so far. What is the best next step in management?