Medical & legal
Medical information
Gender-affirming hormone therapy in South Australia — standards of care, prescribing, informed consent, and resources for GPs and nurse practitioners.
If you are a medical practitioner (GP, nurse practitioner etc.) seeking information about supporting a transgender or gender-diverse patient, this page may assist you. It is also here for patients — knowing what your prescriber is working from makes the conversation easier.
Standards of care
SA Health Statewide Gender Diversity Model of Care
The Statewide Gender Diversity Model of Care (MOC) has been developed to improve timely access to appropriate and evidence-based gender health care and support for South Australians who are trans, gender diverse, non-binary or gender questioning and their families and carers, and to establish clear pathways for service access. The MOC describes how health services will be delivered, including who the services are for, how they can be accessed and the types of services available.
AusPATH: Australian Informed Consent Standards of Care for Gender Affirming Hormone Therapy
Revised from 2022, the 2025 Version 2 of the Standards of Care provide clear, practical guidance for GPs and other primary care clinicians delivering safe, evidence-based gender-affirming hormone therapy. It outlines an informed-consent model tailored to Australian primary care, supports clinicians in managing common clinical scenarios, and helps reduce barriers to care for transgender and gender-diverse adults. The Standards also describe the legal and clinical considerations for adolescents, people in care, and others requiring additional safeguards.
Guidelines for Gender Affirming Healthcare — Aotearoa New Zealand
An in-depth document utilising informed consent models, with practitioner information for initial assessment, prescribing, and ongoing care.
Education and background
The TransHub website includes information and education resources to empower medical providers to be better informed about health care provision, including prescribing, for trans and gender-diverse patients. It also educates patients on what they may expect on their transition journey.
These documents can help ensure people have a clearer understanding of hormone therapy and break down some myths:
Informed consent forms
For medical practitioners prescribing gender-affirming hormone therapy:
Under 18s
The Australian Standards of Care and Treatment Guidelines for trans and gender diverse children and adolescents (ASOCTG) aim to maximise quality care provision to transgender and gender-diverse children and adolescents across Australia, while recognising the unique circumstances of providing such care to this population.
An additional resource is the Center of Excellence for Transgender Health at the University of California, San Francisco, which provides guidelines of care for gender-affirming care of transgender and gender-diverse persons. This is a very in-depth resource and highly regarded.
Refer to the youth section of our website for more information.
Testosterone prescribing
The community group TransMascSA put together a resource to help people and their GP or medical professional use the informed consent model, to empower doctors and patients to prescribe gender-affirming hormone therapy.
Primoteston injectable 200mg is no longer on the PBS and has been written on private prescription since 1 February 2018. This means any GP or nurse practitioner can feel confident writing this prescription without requiring a specialist health provider to authorise it.
For trans masculine folk wishing to access hormone therapy (not including Primoteston), it can be a bit muggy knowing how to access anything — hopefully this clears it up. The following is taken directly from the PBS federal guidelines under Medicare. Of importance are the guidelines applicable for most (not all) trans masc people:
Authority Required
Androgen deficiency (THSA note — this is the most applicable to trans masc folk)
Clinical criteria: Patient must have an established pituitary or testicular disorder.
Treatment criteria: Must be treated by a specialist paediatric endocrinologist, specialist urologist, specialist endocrinologist or a Fellow of the Australasian Chapter of Sexual Health Medicine; or in consultation with one of these specialists; OR have an appointment to be assessed by one of these specialists. The name of the specialist must be included in the authority application.
This means a general practitioner or nurse practitioner can prescribe once a referral has been written and an appointment made to a specialist as noted above.
THSA notes that in no way is this an endorsement not to access health professionals and specialists if it is of clinical value to the patient. THSA values the work of practitioner specialists such as endocrinologists and sexual health physicians, and encourages folk to access the services they need in collaboration with their general practitioner. This does, however, empower GPs and NPs who feel capable and competent to provide a service, to know they are able to do so without the need of a psychologist or psychiatrist if not deemed required for the individual. Trans health care is not specialist health care.
Medication prescribing for transgender women and trans-feminine people
Medications prescribed to those presumed male at birth (PMAB) do not have the same PBS and Medicare restrictions as testosterone. For example, androgen blockers such as spironolactone or cyproterone are considered "General Schedule" and do not have any "Authority" requirement, as are medications containing estrogen/oestradiol.
Trans Health SA acknowledges this means a suitably educated medical practitioner can prescribe these medications, however it is highly encouraged to do so via a trained and experienced provider in trans and gender-diverse health.
Position statement on hormonal management
This resource can help provide support for medical practitioners when prescribing hormones, and can be used as a guide in doing so.
Training and CPD
ASHM & ACON's Trans and Gender Diverse Sexual Health Care e-learning
Co-designed and developed for clinicians working in a sexual health clinical setting or delivering sexual health care in primary health care settings. It consists of five modules that should be completed in sequential order, taking approximately one-and-a-half hours in total. The modules cover: trans and gender-diverse community; sex and sexual health; trans people and reproductive health; an introduction to gender-affirming health care; and creating safe and inclusive environments.
Advanced Gender Affirming Hormone Therapy (GAHT)
Co-designed and developed for eligible prescribers of gender-affirming hormonal therapy, including those working in a sexual health clinical setting or delivering sexual health care in primary health care settings. By the end of this course, learners will be able to:
- Assess clients holistically in prescribing GAHT, including but not limited to pharmaceutical contraindications, fertility, contraception, sexual function, disease prevention and adverse health outcomes.
- Implement an informed consent model of care in prescribing GAHT.
- Interact with clients respectfully, making them feel comfortable by creating an affirming, safe and inclusive environment beyond the clinical consultation.
- Integrate effective referral pathways to seek expertise and coordinate care for clients, their partners and families.