Background Chronic cluster headache (CH) affects around one in 10. 000 people. some of them are resistant to a multitude of treatments. Case We present a case report of a patient with treatment resistant chronic CH which has significantly improved in the setting of gender-affirming care and hormonal treatment with cyproterone acetate and estradiol. https://missouriquiltcoes.shop/product-category/10-square-layer-cake-patterns/