Cross-sex hormone treatment of transgender• Sometimes used as an umbrella to describe anyone whose identity or behaviour falls outside of stereotypical gender norms. More narrowly defined, it refers to an individual whose gender identity does not match their assigned birth gender. Being transgender does not imply any specific sexual orientation (attraction to people of a specific gender). Therefore, transgender people may additionally identify with a variety of other sexual identities as well.
• An umbrella term used to include transsexual people, transvestites and cross-dressers, as in “the transgender community.”
• This is an umbrella term that applies to anyone who does not feel that their gender identity (e.g., identifying as male, female, or other) matches their anatomical/bio- logical sex.
• An umbrella term for people whose gender identity and/or expression differs from that of their sex assigned at birth. Transgender people may or may not alter their bodies to better fit with their gender identity through means such as hormones or surgery. Some intersex people identify as transgender but the two are not the same. Identities such as transsexual or transvestite are distinct sub-categories of transgender and should not be used as synonyms. Should only be used as an adjective e.g. ‘transgender people’. The word “Transgendered” is used by some people but its use is discouraged.
adults leads to very few long-term side effects, according to the authors of the largest study to date to examine this issue.
More than 2000 patients from 15 US and European centers participated in the retrospective study, called “Comorbidity and Side Effects of Cross-Sex Hormone Treatment in TranssexualThis is typically used to describe people who identify as transgender who are transitioning toward the gender with which they identify. This may include socially presenting (e.g., clothing, hair, mannerisms, overall gender expression) as the gender with which they identify, or it may include more extensive changes like taking hormones and/or surgical procedures to modify their body. Subjects”, and nearly 1600 received at least 1 year of follow-up, the authors reported.
“Our results are very reassuring,” principal investigator Henk Asscheman, MD, PhD, who heads HAJAP, his clinical research company in Amsterdam, the Netherlands, told Medscape Medical News. “There are mostly minor side effects and no new [adverse events] observed in this large population.”
Speaking at ICE/ENDO 2014 last week, where he presented the initial results of the research, Dr. Asscheman said the data confirm findings from smaller studies published in the past decade.
“The take-home message,” he said, “is that when using the guidelines from the Endocrine Society ’Endocrine Treatment of TranssexualThis is typically used to describe people who identify as transgender who are transitioning toward the gender with which they identify. This may include socially presenting (e.g., clothing, hair, mannerisms, overall gender expression) as the gender with which they identify, or it may include more extensive changes like taking hormones and/or surgical procedures to modify their body. Persons’ https://www.tgmeds.org.uk/doh-transgender-experiences.pdf, you are not going to see a lot of comorbidities with cross-sex hormone treatment.”
Venous Thromboembolism Lower Than Prior Reports
The primary serious side effect, venous thromboembolism, occurred in 1% of persons undergoing male-to-female (MTF)May refer to a person assigned male at birth whose gender is female all or part of the time; transitioning-to-female; female-to-male spectrum. transgender• Sometimes used as an umbrella to describe anyone whose identity or behaviour falls outside of stereotypical gender norms. More narrowly defined, it refers to an individual whose gender identity does not match their assigned birth gender. Being transgender does not imply any specific sexual orientation (attraction to people of a specific gender). Therefore, transgender people may additionally identify with a variety of other sexual identities as well.
• An umbrella term used to include transsexual people, transvestites and cross-dressers, as in “the transgender community.”
• This is an umbrella term that applies to anyone who does not feel that their gender identity (e.g., identifying as male, female, or other) matches their anatomical/bio- logical sex.
• An umbrella term for people whose gender identity and/or expression differs from that of their sex assigned at birth. Transgender people may or may not alter their bodies to better fit with their gender identity through means such as hormones or surgery. Some intersex people identify as transgender but the two are not the same. Identities such as transsexual or transvestite are distinct sub-categories of transgender and should not be used as synonyms. Should only be used as an adjective e.g. ‘transgender people’. The word “Transgendered” is used by some people but its use is discouraged.
transition• The social, psychological, emotional and economic processes that a trans person undergoes to move from their assigned gender role into their chosen or acquired gender. The time this takes is variable and depends on the individual’s ability to embrace significant change in their life. If requiring genital surgery the individual will have to undergo a so called Real Life Test, i.e. living in their acquired gender role for a minimum of 1 year.
• Refers to the process during which trans people may change their gender expression and/or bodies to reflect their gender, including changes in physical appearance (hairstyle, clothing), behaviour (mannerisms, voice, gender roles), identification (name, pronoun, legal details), and/or medical interventions (hormone therapy, gender-affirming surgery).
and was due to estrogen treatment.
Dr. Asscheman said although this incidence is still high, it is lower than reported in the past.
Among the 1596 adults who completed follow-up, 1073 were MTF and 523 were femaleA sex, usually assigned at birth, and based on chromosomes (e.g. XX), gene expression, hormone levels and function, and reproductive/sexual anatomy (e.g. vagina, uterus). to maleA sex, usually assigned at birth, and based on chromosomes (e.g. XY), gene expression, hormone levels and function, and reproductive/sexual anatomy (e.g. penis, testicles). (FTM). The MTF group had a mean follow-up of 5.6 years and a mean age of 35.0 years, and on average, the FTM group had a follow-up of 4.5 years and age of 27.5 years.
More than 70% of the MTF group received cyproterone acetate (in Europe) or spironolactone, as an antiandrogen, in addition to estrogen treatment, he noted.
Among FTM subjects, more than 90% received intramuscular or topical (gel) testosterone administration.
The diagnosis of “comorbidity,” Dr Asscheman said, was made either by another medical professional or by a prescription for a relevant medication.
At entry into the study (baseline), the most common comorbidity in both groups was depression, with a 24.9% incidence in MTF subjects and 13.6% in FTM, according to Dr. Asscheman. He noted, however, that the frequency of depression varied greatly among the study centers.
Even after treatment, 26 (2.4%) of the MTF subjects and 7 (1.4%) of the FTM subjects still reported depression, leading Dr. Asscheman to tell the large audience, “Sex-reassignment treatment does not cure depression.”
Other reported pretreatment comorbidities are shown in the table.
Comorbidities Before Transgender Hormonal Therapy
Unexpected Findings: Hypothyroidism and Male Cancers
An incidence of hypothyroidism greater than 2% in a population that was largely younger than 40 years is surprising, according to Dr. Asscheman, who said he would expect it to be closer to 1% in these younger adults.
However, 1 conference delegate said a 2% incidence of hypothyroidism in this sized population is likely.
Furthermore, session cochair Linda Nelson, MD, PhD, a reproductive endocrinologistA medical doctor specially trained in the study of hormones and their actions and disorders in the body. from the University of Arizona College of Medicine, Phoenix, told Medscape Medical News thehypothyroidism rate may be unrelated to gender-dysphoria disorder or hormonal treatment.
Another unexpected comorbidity, according to Dr. Asscheman, was the occurrence of 7 male-specific cancers. He said this finding needs confirmation in other studies.
After cross-sex hormone treatment, side effects in MTF subjects, other than venous thromboembolism, included weight gain, reported in 5 persons (0.5%). In addition, 4 MTF subjects (0.4%) had a myocardial infarction, and 1 (0.1%) experienced a stroke. Hypertension was also common in this group, Dr. Asscheman stated.
The FTM subjects most often had the following side effects: acne with local treatment (2.9%, n = 15), weight gain (0.4%; n = 2), muscle pain (0.4%; n = 2), and liver-enzyme abnormalities (0.4%; n = 2).
One of Largest Database of Transgender Therapy; Results Reassuring
Dr. Asscheman noted several limitations of the retrospective study, including small numbers of patients with follow-up longer than 10 years or with an age above 60 years. In addition, some diagnostic rates differed between US and European centers.
A strength of the study, according to cochair Dr. Nelson, who was not involved with the research, was the size of the patient population. She called it “one of the biggest databases so far” of transgender• Sometimes used as an umbrella to describe anyone whose identity or behaviour falls outside of stereotypical gender norms. More narrowly defined, it refers to an individual whose gender identity does not match their assigned birth gender. Being transgender does not imply any specific sexual orientation (attraction to people of a specific gender). Therefore, transgender people may additionally identify with a variety of other sexual identities as well.
• An umbrella term used to include transsexual people, transvestites and cross-dressers, as in “the transgender community.”
• This is an umbrella term that applies to anyone who does not feel that their gender identity (e.g., identifying as male, female, or other) matches their anatomical/bio- logical sex.
• An umbrella term for people whose gender identity and/or expression differs from that of their sex assigned at birth. Transgender people may or may not alter their bodies to better fit with their gender identity through means such as hormones or surgery. Some intersex people identify as transgender but the two are not the same. Identities such as transsexual or transvestite are distinct sub-categories of transgender and should not be used as synonyms. Should only be used as an adjective e.g. ‘transgender people’. The word “Transgendered” is used by some people but its use is discouraged.
patients receiving hormone therapy.
“Some side effects are expected, such as venous thromboembolism with estrogen use, but most of the results are really reassuring,” she concluded.
Source – Joint Meeting of the International Society of Endocrinology and the Endocrine Society: ICE/ENDO 2014; June 24, 2014