Menopausal Considerations in Transgender and Gender-Diverse Individuals.

Assessing and treating menopause in transgender and gender diverse (TGD) individuals is of increasing interest to clinicians providing gender-affirming care. There currently exists a small body of literature that describes cardiovascular, bone health, neurocognitive, and other outcomes in the TGD population who experience loss of endogenous sex hormone production, whether through gender-affirming hormone therapy, surgical gonadectomy, or natural aging. However, the literature is currently insufficient to provide clear evidence-based guidance for the medical management of menopause in TGD individuals. As a result, clinical care largely relies on extrapolation from cisgender populations, expert opinion, clinical consensus, and shared decision-making.