This leaflet is an introduction to your treatment course at the Centre for Gender Identity. You can read about a typical treatment course at the Centre for Gender Identity and what you can expect.
Most people who are referred to the Centre for Gender Identity are seeking treatment, but it is also possible to receive consultations if you need further clarification of your gender identity.
Your first consultation at the Centre for Gender Identity will focus on your needs and any wishes you may have for treatment.
The first consultation
The first consultation will take place at the Centre for Gender Identity. The consultation will take approximately one hour.
During the consultation, we will discuss the following with you in to determine how we should plan your diagnostic evaluation:
- Gender identity, including gender dysphoria
- Plans and considerations regarding changing your name and Danish civil registration number (CPR)
- Wishes for treatment
- Sexuality
- Childhood/adolescence and family situation
- Schooling, education and employment
- Current social conditions (housing, financial situation, etc.)
- Your current well-being
- Physical diseases and mental disorders, including family health history
- Any medication you may be taking
- Allergies
After the consultation, the Centre for Gender Identity will make a plan for your diagnostic evaluation, and you will be notified of the plan as soon as possible.
Diagnostic evaluation
In most cases, diagnostic evaluation will include up to six consultations with a practitioner at the Centre for Gender Identity. During the consultations, we will talk about your gender identity, daily life and your overall well-being.
We will discuss your wishes for treatment, and the practitioner will inform you about available treatment options.
You will also speak with the physicians who manage hormone therapy because it is important to assess whether there are any health-related issues that must be considered in connection with hormone therapy.
During your consultations with the physicians, you will learn more about what hormone therapy will entail and how it is carried out.
During the diagnostic evaluation, it may be necessary for us to discuss your treatment with other practitioners/physicians, for example if you are undergoing treatment by a medical specialist, your general practitioner or by the mental health services. We do this to ensure that the different treatments are aligned.
The diagnostic evaluation will take approximately six to eight months.
Subsequently, your practitioner at the Centre for Gender Identity will discuss your case at a multidisciplinary team conference with the other practitioners and the physicians who prescribe hormone therapy participate. This team will decide whether you can be offered hormone therapy.
You will be informed of their decision by letter.
Starting of hormone therapy
If you are offered hormone therapy, you will be given a prescription for hormones within 14 days of the conference and then you can start your treatment.
There will be follow-ups scheduled after three months, six months and one year. After this, there will be a yearly follow-up.
Follow-up will usually include a blood test, which will be used to evaluate your hormone therapy treatment, and determine, together with you, the effectiveness of treatment and the need for any adjustments of doses.
There may be a need for other examinations, including a gynaecological examination.
Top surgery
If you would like to have surgery, we will listen to your wishes and make sure that you are thoroughly informed of your options, the risks and the expected results.
Removal of breasts (assigned female at birth)
If you are offered hormone therapy, you will often be offered the option of breast removal surgery (a mastectomy) as well. However, the final decision to offer surgery will be made by a plastic surgeon, typically 6-9 months after you have started hormone therapy.
We will schedule the consultation with the plastic surgeon when you begin hormone therapy.
Breast augmentation surgery (assigned male at birth)
You will develop breasts during hormone therapy. However, we cannot predict the degree of your breast development. If you are interested in breast augmentation surgery, a plastic surgeon will assess whether the procedure can be offered to you by the public health services. This assessment will be done after you have been in hormone therapy for at least two years. In general, the surgery is offered if your breasts do not fit the proportions of the chest area.
Bottom surgery (genital organ surgery)
If you are interested in bottom surgery, this may be an option after 12 months of hormone therapy, at the earliest. You can discuss this with the physician who is responsible for your hormone therapy during your appointments. It is important to underline that, even though you have been offered hormone therapy, it does not mean that you also will be offered bottom surgery.
Types of surgeries
For people assigned female at birth, surgeries on internal genital organs include the removal of the uterus, fallopian tubes and ovaries. Surgeries on external genital organs for people assigned female at birth include the removal of the vagina and the shaping of a penis-like organ.
For people assigned male at birth, surgery of external genital organs include the removal of the penis and scrotum, and the shaping of a vagina. A wish to solely remove the testes (keeping the penis and scrotum) may impact the possibility of shaping a vagina later in life. It is important to be aware of this and it must be discussed with the plastic surgeon prior to surgery.
If you want bottom surgery
If you want bottom surgery, you will be invited for an additional two to three consultations at the Centre for Gender Identity and be invited for an informative consultation with a plastic surgeon.
During the consultations, we will ask about your wishes and the reasons behind them. We do so to ensure that we do not treat anyone who is not completely sure about what they want, and to make sure that a person is fully aware of the consequences of the surgery.
You will be thoroughly informed about the different types of surgeries, how they are carried out, the risks involved and the consequences of surgery, for example in relation to sexuality and fertility.
Surgery is much more radical than medical treatment. It is necessary to ensure that the decision has been carefully considered and that it is the right solution for you.
According to the Danish Health Authority's guidelines regarding treatment of people with gender identity issues, the medical treatment of gender dysphoria must be attempted for a long period of time before bottom surgery is offered. The Centre for Gender Identity follows these guidelines even though we are aware that, in some cases, this will prolong the waiting time for the desired surgery.
The decision to offer you surgery or not will be decided at a multidisciplinary conference attended by practitioners, plastic surgeons, and gynaecologists. This is done to ensure that all elements of treatment and its course are considered.
You will be informed of the decision either by letter or phone call or during a follow-up visit.
You can read more about our treatments on our website rigshospitalet.dk/cki
Change of name and civil registration number (CPR)
Change of name
If you want to change your name, you can apply for this by contacting the Agency of Family Law (Familieretshuset):
familieretshuset.dk/en
Change your Danish civil registration number (CPR)
If you want to change your civil registration number (CPR number), you should contact the Civil Registration System:
cpr.dk/borgere
Note that it can take up to six months for your civil registration number to change after applying.
Additional treatment options
Laser treatment
For people assigned male at birth, we offer laser hair removal of unwanted facial hair growth. If you are a resident of the Region of Zealand, you will need to be referred to a dermatologist by your general practitioner. If you are a resident of the Capital Region of Denmark, you can be referred to the Department of Dermatology at Bispebjerg Hospital, which offers six laser treatments.
Sperm storage
People assigned male at birth who are offered hormone therapy, will also be offered the option of depositing, and storing their sperm. This will take place at the sperm bank at Copenhagen University Hospital (Rigshospitalet). This must be done before beginning hormone therapy.
Prosthetic penis
People assigned female at birth are given the option of a prosthetic penis if they are not going to undergo surgery or during the waiting time prior to surgery. It is custom made according to your wishes. This service is not offered by the Centre for Gender Identity. However, you can apply to your municipality for a subsidy as it can be considered an aid. The price of a prosthetic penis is between DKK 15,000 and DKK 30,000. For additional information, visit the following website: partsprosthetic.dk/english
Chest binders
For people assigned female at birth, a chest binder can be used to reduce the size of the chest area. We recommend that you do not use a binder for more than 6-8 hours a day. You should always remove it before going to bed. You can apply to your municipality for a subsidy.
Vocal lessons
Contact your municipality if you are interested in vocal lessons. Several municipalities offer vocal lessons for transgender people but, unfortunately, not all municipalities. You can find more information about vocal lessons on our website. You can also find information at: dths.dk/transkoennede/
Make-up courses
The Centre for Gender Identity collaborates with a cosmetics company that offers make-up courses for transgender people. The courses are held in person or online. You can find more information about upcoming courses and how to sign up on our website. Visit rigshospitalet.dk/cki
Support groups (only Danish speaking)
You are welcome to participate in our support groups, where you can meet other people who are also in treatment at the Centre for Gender Identity.
You can find more information about upcoming dates for support groups and how to sign up on our website. Visit rigshospitalet.dk/cki
Research at the Centre for Gender Identity
The Centre for Gender Identity is involved in various research projects. You may be asked to participate in a project. You will always receive detailed information about the specific project.
We want you and others have a positive experience at the Centre for Gender Identity. We therefore continuously evaluate patient satisfaction in order to improve it. We are aware that there is always something that can be done differently and better.
To better understand our patients’ perspectives on some of our initiatives, we have established a patient group of user representatives. For example, the group provides us with input on written information for patients.
One of our current projects is the Cohort of Gender Identity.