Authors: Dr Sav Zwickl and A/Prof Ada Cheung.
Content Warning: This article contains brief mentions of psychological distress, life satisfaction and gender congruence.
A trans woman. Credit: Supitnan via Adobe Stock.
There is no consensus on optimal oestradiol levels for trans people using oestradiol gender-affirming hormone therapy (GAHT). International guidelines vary, suggesting goal oestradiol concentrations anywhere between 250 pmol/L and 1000 pmol/L, but these recommendations are based on expert opinion and the approximate range for cisgender women across the menstrual cycle, rather than clinical evidence.
Over the last few years, we have observed an increase in trans people in Australia seeking high doses of oestradiol, while their doctors understandably have reservations about prescribing oestradiol GAHT well above levels recommended in current Australian guidelines.
