The primary investigations and starting the hormonal treatment of transsexual persons takes place in Helsinki and Tampere University hospitals as part of the real life period. The hormones used are estrogen and anti-androgen for MtoF and testosterone for FtoM persons. The medication suppresses the endogenous sex-hormone production and brings about the desired features of the other sex. While the recommended doses result in physiological hormone levels, higher doses do not hasten or increase the desired changes and are a health risk. After the transition period, the follow up is referred to the person's home district. The physical and psychological status and laboratory values are evaluated at the yearly follow-up doctor visits. Although the hormone doses are lowered and percutaneous administration route is favored upon aging, stopping the medication is not recommended.