Question special

I am curious to hear about common challenges encountered when treating transgender patients with cross-sex hormone therapy and how you approach them. For purposes of clarity, I am discussing treatment for patients with persistent gender dysphoria, who do not feel that their natal sex (genitalia they were born with) is in congruence with their gender identity, and that incongruence is causing distress.

I am also curious to hear - do you have patients sign consent for cross-sex hormones? Is there a more PC term for cross-sex hormone treatment? And for female to male patients (born as female but identify as male, also called transgender men), do you typically have them do subcutaneous testosterone as opposed to IM? How do you arrange for teaching of this skill in your clinic?