For many years, hormonal and surgical treatment of persons deemed to have gender dysphoria was offered almost covertly by a handful of endocrinologists and surgeons as a tiny part of their practice. With the enormous increase in social acceptability of transgendered people in parts of the world, this area has become a hot topic from medical school to subspecialty fellowship programs. High-visibility guidelines for care have been developed and transgender specialty clinics are now widely available in North America and Europe. This session will be focused upon the current definitions, processes and practices currently used by transgender clinics with additional review of potential safety concerns. Potential ethical and societal questions and global acceptance of transgender medicine may be raised to stimulate later discussions.