Endocrine Abstracts (2017) 49 EP1178 | DOI: 10.1530/endoabs.49.EP1178

Evolution of healthcare demand in a public gender identiy clinical center in Valencia (spain)

Victor Atienza Moya1, Marcelino Gomez Balaguer1, Felipe Hurtado Murillo2, Santiago Garcia Torres1, Eva Maria Riera Sabater1, Christian Salim Vendrell1 & Antonio Hernandez Mijares1,3

1Endocrinology Service, Doctor Peset University Hospital, Valencia, Spain; 2Sexual psychology and reproductive health unit, Doctor Peset University Hospital, Valencia, Spain; 3Medicine department, University of Valencia, Valencia, Spain.

Introduction: The prevalence of transsexuality in Europe is uncertain in absence of epidemiological studies, so it’s difficult to implement public healthcare strategies.

Aim: To describe healthcare demand evolution in a gender identity clinical service in our country.

Methods: Our center is a public university hospital placed in Valencia (Spain). It is a reference center on gender dysphoria from two provinces (Valencia and Castellon), with a target population of 2.646.801 inhabitants ≥14 years old (50.8% women and 5.5% adolescents). We reviewed medical records of patients referred from 2008 to 2016, excluding gender-non conforming people without demand of hormonal or surgical intervention.

Results: We attended 331 transsexual people with eligibility criteria for pubertal block, cross hormonal treatment or surgery; 41.7% transsexual men (FxM) and 58.3% transsexual women (MxF). 6% in FxM and 30% in MxF had previously started any kind of treatment. 82% FxM and 56% MxF were living in desired role at the initial evaluation. Before 2011 no adolescent was referred while between 2012 and 2016 were attended 82 of them. In adolescents, sex ratio was favoring natal males before 2014 (2.9:1) and it changed in 2015 and 2016 (1.7:1–1:1.5, respectively) favoring natal female. Minors represented 16% of patients in 2012–2014 and 52% nowadays. We performed 34 hysterectomies (34.6% of patients older than 18 years), 25 mastectomies (25.5%) and implanted 20 breast prosthesis (13.1%), surgeries preformed in private centers were not accounted. For genitoplasty surgery they were referred to another national surgery center.

Conclusions: Demand for transexual care shows an important increase in our geographical area. This increase is due to adolescent population. There is a significant variation of sex ratio favoring transsexual men. This results can be explained by sociocultural phenomena. Only one-third of FxM choose to perform hysterectomy and adnexectomy.

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