Dawaa Reference

Clinical reference

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.