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EAU18 – MDT approaches are crucial in transgender healthcare

The role of psychology, endocrine treatment, and vaginoplasty techniques were some of the topics explored today during Thematic Session 19: Transgender healthcare: A primer for the urologist, which was chaired by Dr. Maarten Albersen (BE) and Dr. Giulio Garaffa (GB).

“Involving psychology is advisable within all phases of treatment. I urge urologists to involve psychologists in the consultation and the follow-up,” stated psychologist Dr. Thomas Steensma (NL), underscoring the importance of multi-disciplinary (MDT) collaboration in transgender health.

In his lecture “Psychological evaluation and outcomes for transgenders: What the urologists needs to know”, he pointed out that gender is a spectrum. “Gender is how one feels and identifies,” said Steensma. “And treatment wishes can vary greatly. The role of psychology consists of exploring treatment wishes and future expectations, psychological evaluation of ‘burden and capacity’, psychological and social functioning to name a few.”

“Body changes induced by hormonal treatment are effective in alleviating psychological distress and improving body satisfaction,” said Dr. Alessandra Daphne Fisher (IT) in her lecture “Gender-affirming endocrine treatment.” Fisher stated that the two main endocrine treatment goals for transgender women include reducing the secondary sex characteristics of the natal gender and to induce those of the desired gender.

Surgical techniques
Modern vaginoplasty techniques have evolved to focus on cosmetic and functional outcomes, according to Ms. Tina Rashid (GB). “Results of using modern techniques are excellent; more than 80% achieve orgasm and more than 85% are satisfied with the cosmetic results,” said Rashid during her lecture “Vaginoplasty techniques in the Male to Female (MtF patient)”. She stated that surgery has shown a 97% positive impact on patients.

“The most demanding of all urethroplasties is the creation of a very long urethra from tissues unaccustomed to urine environment,” stated Dr. Rados Djinovic (RS) in his lecture “Managing the urethra of the Female to Male (FtM) patient”.