Use of the Informed Consent Model in the Provision of Cross-Sex Hormone Therapy: A Survey of the Practices of Selected Clinics

ABSTRACT

Introduction: Some clinics have developed models for the initiation of cross sex hormone therapy (csHT) without an in-depth mental health evaluation and referral. These approaches have also been referred to as the informed consent (IC) model.

Aims: (a) Survey practice characteristics of clinics utilizing the IC care model; (b) assess potential legal risks to clinics utilizing the IC care model; and (c) assess for any known cases of regret by patients with respect to csHT.

Methods: (a) Convenience sample survey instrument distributed at professional conferences and online and (b) thorough online legal literature search.

Results: Responses were obtained from 12 unique U.S. sites. Seventeen known cases of regret were reported across all sites. No cases of malpractice claims or judgments relating to regret about the use of csHT were reported. Only 4 of 12 sites required any contact with a mental health provider prior to initiation of csHT. A minimum number of visits prior to beginning treatment was required by only 5 clinics. The literature review yielded no related legal actions.

KEYWORDS:

• Informed consent
• hormone
• malpractice
• outcome
• harm reduction

ACKNOWLEDGMENTS

The author wishes to acknowledge Amy Atchison; Marvin Belzer, MD; and Howard J. Deutsch, PhD, for their input in the preparation of this manuscript.