Dawaa Reference

chronic

Gender Incongruence

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources3 sources

Gender Dysphoria - StatPearls - NCBI Bookshelf (NBK532313) - https://www.ncbi.nlm.nih.gov/books/NBK532313/ · ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class PS08 - condition scope only, no dose · No dose - referral pathway, no medicine given in primary care

Verified against2 documents
  • No dose - referral pathway, no medicine given in primary care
  • Gender Incongruence - disease-level clinical article (gender-incongruence-full.txt)

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Symptoms — what the patient reports (5)

  • A full history covers psychiatric, substance use, social, family, and developmental factors, including any trauma or past suicide attempts
  • In children, diagnosis needs at least six of eight listed features present for at least six months, including a strong desire for the other gender
  • In adolescents and adults, at least two of six listed features must be present for at least six months to meet criteria
  • Red flag: the stigma and the rejection bring depression and anxiety, substance use, a poor sense of well-being and low self-esteem, and a raised risk of self-harm and of suicide [anxiety · low mood · suicidal thoughts]
  • A child or adolescent who cannot see themselves in the traditional binary male or female roles may meet cultural stigmatisation for it [loss of vision]

Signs — what you find (3)

  • A newborn genital exam can reveal ambiguous genitalia from congenital adrenal hyperplasia or androgen insensitivity syndrome
  • Congenital adrenal hyperplasia can show early dehydration, low sodium, and high potassium, or virilization in the late-onset form [dehydration · virilisation]
  • Androgen insensitivity syndrome means a genetically male patient does not respond to androgens and is often raised as female

Tests (1)

  • Genetic testing is warranted for anyone born with ambiguous genitalia

If not this — what else fits (9)

  • Autogynephilia
  • Body dysmorphic disorder
  • Intersex states (disorders of sex development)
  • Psychosis
  • Paraphilic disorders
  • Self-amputation
  • Schizophrenia
  • Transvestitism
  • Gender is not sexual orientation: a transgender man, born female, may identify as heterosexual and still be attracted to women

SourceStatPearls "Gender Dysphoria" - disease-level clinical article

Presentation findings are traced to the source above.

1

NO DRUG THERAPY IN PRIMARY CARE (REFERRAL & ADVICE)

1st line
Adult dose and duration

A marked, persistent incongruence between experienced gender and sex assigned at birth; in the Egyptian context this is a recognise-and-refer presentation where the GP listens respectfully and refers to psychiatry/endocrinology, since hormonal or surgical management is specialist-led and there is real uncertainty about how consistently such referral pathways are available locally. - Refer, with advice

Paediatric dose

Children follow the same pathway: recognise and refer. No primary-care medicine is implied.

Dose source

No dose - referral pathway, no medicine given in primary care

Why

A marked, persistent incongruence between experienced gender and sex assigned at birth; in the Egyptian context this is a recognise-and-refer presentation where the GP listens respectfully and refers to psychiatry/endocrinology, since hormonal or surgical management is specialist-led and there is real uncertainty about how consistently such referral pathways are available locally.

Cautions
  • Rare in Egyptian primary care.
  • No medicine is prescribed for this in primary care - this entry is for recognition and referral. Anything given is decided by the service it is referred to.
  • RED FLAG - There is a high risk of self-harm and suicidality, requiring active suicide risk assessment and psychiatric safety netting.
  • RED FLAG - There is a high prevalence of comorbid psychiatric disorders and substance abuse.

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.