Wednesday, November 13, 2019

Elizabeth Danzberger, or “Liza” as she likes to be called, is a 20-year-old college student with aspirations to complete her computer science degree and explore the world beyond her Elizabethtown home. 

I love learning languages, so I suppose a future endeavor of mine is to travel to various countries and be a part of a new culture,” said Danzberger.

Unfortunately, Danzberger says her future didn’t always look so bright. Around the time she was in middle school, she started to feel depressed.

“I missed school. When I did go to school, I could not focus and didn't feel comfortable talking to any of my friends or doing anything else a kid should do in school,” explained Danzberger. “I felt completely disgusted with my body, which I thought was typical of kids my age at the time.’

That’s when Danzberger stopped going completely and attended class online until she graduated high school; but her feelings of depression never went away.  She turned to the Internet to find a solution.

Becoming Elizabeth

“I discovered the term ‘gender dysphoria’ and read some articles; it summed up everything I was experiencing pretty well.” 

Gender dysphoria is a condition where a person experiences discomfort or distress because their biological sex does not match their gender identity. This stress is often resolved by prescribing a treatment using hormones that match a person’s gender identity.

A therapist formally diagnosed Danzberger with gender dysphoria and wrote a recommendation to see an endocrinologist for hormone replacement therapy.

“I was so happy to have this letter, but I did not know where to go with it,” recalled Danzberger. “I did not think there would be any doctors in my area that would be willing to oversee this treatment.”

Danzberger scheduled an appointment with Dr. Kanika Shanker of WellSpan Endocrinology in Chambersburg.

“My interactions with Dr. Shanker have been nothing but amazing,” said Danzberger. “She is such a sweet person and she really cares about every aspect of my transition and wants to help me as much as she can.”

“Gender dysphoria causes a quality of life issue for individuals who feel they are trapped in their bodies,” explained Dr. Shanker. “It is a true joy in my career to be able to help individuals with gender dysphoria gain confidence, happiness and improve their overall mental well-being.”

Danzberger has been receiving estrogen treatments from Dr. Shanker for two years. In that time, she’s realized some powerful changes, and plans to have gender reassignment surgery.

“Seeing my body change has improved my mental state drastically,” explained Danzberger. “My relationship with Dr. Shanker has improved greatly over the two years that I've been going to her office; she would do just about anything for me, within reason.”

For any young person going through a difficult time as they mature, Danzberger offers this advice:

“I know it's hard, and sometimes there are a lot of limitations, but once you get there you will feel so much better. If someone is giving you a hard time about it, it's your life; don't let them discourage you.”


More from the Doctor: Transgender Hormone Therapy

Dr. Kanika Shanker, WellSpan Endocrinology


Everyone has hormones.  They help in development, metabolism, sexual function, reproductive growth and cognitive function. Hormones are produced in many areas of the body including the thyroid, pancreas, pituitary gland, the testes and the ovaries.


According to one study, there are 1.4 million people in the United States who identify as transgender. That means their biological gender and the one they identify with do not match. When individuals go through hormone therapy to transition to the gender they identify, they take hormones to facilitate changes in the body that match their gender identity. It can be years before individuals realize changes in their bodies, it’s as if these individuals are going through puberty for the second time.


For biological men transitioning to female, the estrogen hormone is commonly used to create changes in the body.  This includes breast development, weight distribution around the hips, a softer appearance in and around the face and eyes.  Hair on the body will get thinner and grow more slowly.


For biological women transitioning to male, testosterone hormones will cause the body to begin redistributing weight and muscle definition will begin in the arms and legs.  The vocal cords will get thicker, resulting in a deeper voice. Hair on the body will begin to develop at a faster rate and come in thicker.  Facial hair may begin to grow right away, or it could take some time.


Hormone therapy does not drastically change a person’s genitalia. A transgender person will have to undergo surgery to significantly alter their genitals. It’s important to remember that changes from hormone therapy don’t happen right away and can sometimes take years.  Everybody is different and requires different hormone prescriptions to make visible changes. 


As an endocrinologist, it is my job to help people safely navigate hormone use for gender transition.  I encourage anyone who may be thinking about taking the next step in transitioning to do so with the help of a medically trained therapist or counsellor and an endocrinologist.