Improving care for individuals with gender incongruence: Establishing a multidisciplinary approach in Italy

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PURPOSE: To present a multidisciplinary care model designed to provide personalized gender-affirming care and assess general health for transgender and gender-diverse (TGD) individuals. METHODS: Drawing from our experience in a tertiary center in Padua (Italy), the Interdisciplinary Group for Gender Incongruence (GIIG) model employs a multidisciplinary approach to provide diverse gender-affirmation services. Mental health support, gender-affirming medical and surgical treatments (GAMST), screening programs, and regular follow-up ensure treatment safety and efficacy. The GIIG model promotes collaboration among specialists, primary health services, and LGBTQ + associations. Furthermore, it advocates for training healthcare professionals and raising awareness in the population. RESULTS: The GIIG involves mental health professionals, endocrinologists, surgeons (plastic, urological, and gynaecological), voice specialists, internists, and associations. Associations serve as a point of reference for the community and offer psychological and legal services. Initial contact at the Center is made with MHP, who provide a safe space to explore gender identity, receive information, and support mental well-being. Endocrinologists prescribe hormone therapy and monitor its potential risks and overall health. Surgical interventions include chest, genital, and laryngeal surgery. Internists and other specialists assess osteo-muscular, hemo-coagulative, oncological, and infectious risks. CONCLUSIONS: Our experience emphasizes the need for personalized care tailored to individuals' desires while ensuring the safety of gender-affirming treatments. By adhering to the Standards of Care and offering comprehensive services, our center aims to serve as a model for modern transgender care.

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