Background/Objectives: Gender-affirming care is a complex, multidisciplinary process that has gained increasing recognition worldwide. This practice report presents the unique clinical model developed at the Kocaeli University Hospital Gender Dysphoria Clinic, one of the pioneering centers in Türkiye. Methods: An experience-based descriptive approach was adopted to capture two decades of clinical experience, institutional processes, and socio-political challenges not fully reflected in systematic reviews. The article reflects on the authors’ direct practice in a university-based transgender health clinic in Türkiye, structured around the multidisciplinary team model, patient pathways, institutional processes, and the sociopolitical context of care. Results: The Kocaeli University model integrates psychiatry, endocrinology, surgery, nursing, social work, and legal consultation. Since 2004, the clinic has evaluated and treated hundreds of transgender individuals and produced numerous theses and peer-reviewed publications. Key strengths include a structured board system, the training of psychiatry residents, and close interdepartmental collaboration. Conclusions: This model illustrates how gender-affirming care can be effectively implemented in a challenging sociopolitical context. Sharing this experience may inform global practices and support the dissemination of multidisciplinary approaches to transgender health.

Background/Objectives: Transgender individuals face significant healthcare disparities, often exacerbated by provider prejudice and knowledge gaps. Nurses, as frontline providers, play a critical role in promoting inclusive care. This study aimed to evaluate the levels and predictors of transphobia and attitudes toward transgender individuals among nurses in Türkiye. Methods: A cross-sectional survey was conducted with 100 registered nurses. Participants completed the Transphobia Scale, the Attitudes Toward Transgender Individuals Scale, and the Hudson & Ricketts Homophobia Scale. Additional measures included perceived knowledge, prior education on transgender health, familial attitudes, and comfort levels when working with transgender patients. Multiple linear regression analyses identified predictors of transphobia and attitudes. Results: The mean Transphobia Scale score was 41.53 (SD = 12.67), and the mean Attitudes Toward Transgender Individuals Scale score was 57.45 (SD = 16.42). Greater homophobia, negative parental attitudes, and higher perceived knowledge significantly predicted higher transphobia scores (Adjusted R²= 0.327). Prior education on transgender health was also associated with lower transphobia. Lower comfort with transgender patients was marginally associated with higher transphobia. More positive attitudes toward transgender individuals were predicted by lower transphobia, lower homophobia, and prior education (Adjusted R² = 0.526). Conclusions: Findings underscore the urgent need for structured transgender health education and culturally sensitive interventions among nurses. Addressing sociocultural factors and training gaps could enhance equitable healthcare delivery for transgender populations, particularly in culturally conservative settings like Türkiye.

Background: Neurocognitive functioning in transgender adults remains understudied and is predominantly derived from Western samples, often treated as universally applicable. Evidence from non-Western contexts is limited, despite the potential influence of structural stigma and minority stress on cognition and research participation. Türkiye represents a sociopolitical setting where transgender individuals face significant barriers to healthcare and research. To date, no study has systematically examined the neuropsychological profile of transgender adults in Türkiye using a four-group design. Methods: This retrospective, cross-sectional study was conducted at a multidisciplinary university-based gender identity clinic. Eighty-one adults were included: transgender women (n = 14), transgender men (n = 39), cisgender women (n = 13), and cisgender men (n = 15), with cisgender groups matched for age and education. Participants completed a standardized neuropsychological battery assessing visuospatial abilities, executive functions/processing speed, working memory, and verbal fluency. Group differences were analyzed using nonparametric methods, with additional aggregated transgender–cisgender comparisons. Results: Group differences were observed in visuospatial functioning (Judgment of Line Orientation, Rey–Osterrieth Complex Figure; all p ≤ 0.05) and executive control (Trail Making Test Part B, p = 0.048; B–A difference, p = 0.014). Group-level differences were domain-specific: both transgender groups scored below both cisgender groups on the visuospatial measures, whereas the ordering on executive-control measures differed, and distributions overlapped substantially throughout. Processing speed, working memory, and verbal fluency did not differ significantly (p > 0.05). No clear association between hormone therapy status and performance was detected in this small sample. Conclusions: The observed distributions were domain-specific and substantially overlapping, and should not be interpreted as indicating correspondence between cognitive performance and either gender identity or sex assigned at birth. Differences were domain-specific, with substantial overlap across groups. Findings support a context-sensitive, non-pathologizing interpretation emphasizing sociocultural factors rather than inherent deficits. Longitudinal and cross-cultural studies incorporating psychosocial variables are needed.

Background/Objectives: Most long-term cohort data on gender-affirming care come from adolescent and young adult populations in Western Europe and North America. In a Muslim-majority setting where legal gender recognition is contingent on a court ruling, presentation trends and the care pathway of an adult-service gender dysphoria cohort remain unknown. This single-center, retrospective study describes 15-year presentation trends and the gender-affirming care pathway at a university-based center in Türkiye. Methods: Clinical records of 199 individuals presenting to a university gender identity clinic (2010–2024) were retrospectively reviewed, under routine institutional research consent obtained in writing from patients at intake; nine presented before age 18, and an adult-only sensitivity analysis was performed. Annual presentation counts were modeled with negative-binomial regression (accounting for overdispersion), with separate sub-period slopes estimated from 2015 and from 2017. Care-pathway stages (hormone board, surgical board, legal name change) were defined by board decision dates and cross-tabulated to show their overlap. Time-to-stage was analyzed with Kaplan–Meier estimation (with numbers at risk); predictors of reaching the hormone and surgical boards were assessed with Cox proportional-hazards models, censoring at the database closing date (25 November 2024). Results: The cohort comprised 67.3% trans men (AFAB) and 32.7% trans women (AMAB), approximately 2:1. Median age at presentation was 23.3 years (IQR 20.0–27.6). Annual presentations increased overall (negative-binomial IRR 1.21/year, 95% CI 1.06–1.37, p = 0.003), but the slope weakened from 2015 (IRR 1.07, 95% CI 0.86–1.34) and was flat from 2017 (IRR 0.96, 95% CI 0.70–1.31); neither age at presentation nor the proportion of trans men changed over time. Overall, 51% reached the hormone board, 41% the surgical board, and 31% a legal name change; stages were not strictly nested (12 individuals obtained a legal name change without surgical-board evaluation). In Cox models, endocrine pathology was associated with faster progression to the hormone board but not the surgical board; residence outside the center’s province was associated with lower odds of surgical-board attainment in logistic but not in time-to-event analysis. No prespecified between-group differences by sex assigned at birth were detected. Conclusions: This predominantly adult Turkish cohort shows an overall long-term increase in referrals—concentrated in the earlier years—with age at presentation and the recorded AFAB/AMAB distribution statistically stable across 15 years. Residence relative to the center was associated with surgical-board attainment in exploratory analysis only.