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Safety and rapid efficacy of guideline-based gender affirming hormone therapy: an analysis of 388 individuals diagnosed with gender dysphoria.

Abstract：

OBJECTIVE:Hormone treatment is an important part of gender reassignment therapy in gender dysphoria. Previous data about efficacy and safety are commonly based on small cohorts or they comprise former cohorts under meanwhile obsolet therapy regimes. Our objective was to investigate these topics in a large cohort of individuals under guideline-based treatment. DESIGN/METHODS:Cohort study of medical files of n=155 male-to-female (transwomen) and n=233 female-to-male transgender persons (transmen) of an Endocrine outpatient clinic between 2009 and 2017. RESULTS:Median time to reach amenorrhoea in transmen under testosterone monotherapy was three months, regardless whether testosterone undecanoat or gel was used. Transmen with higher levels of hemoglobin 3-4 month after onset of GAHT had a greater chance to reach amenorrhea early, whereas testosterone levels showed no significant correlation (hemoglobin: HR 1.639; 95 % CI 1.036-2.591, p=0.035; testosterone: HR 0.999; 95 % CI 0.998-1.001, p=0.490). Estradiol levels (ρ -0.117; p=0.316) had no significant influence on breast development in transwomen. Testosterone levels (ρ -0.398; p<0.001) and FAI (ρ 0.346; p=0.004) were significantly negatively correlated with reached tanner stage. Liver values and blood lipids showed an alignment to reference range of the required sex in both groups. Relevant elevations of liver values were rare (2.44 % in transmen, 4.23 % in transwomen) and transient in most cases. Most relevant side effects were acne (44.8 %), respectively erythrocytosis (up to 5.6 %) in transmen and venous thrombembolism (1.9 %) in transwomen. CONCLUSIONS:Gender affirming hormone therapy in accordance with current clinical-practice guidelines is efficient and safe.

journal_name

Eur J Endocrinol

journal_title

European journal of endocrinology

authors

Meyer G,Mayer M,Mondorf A,Fluegel AK,Herrmann E,Bojunga J

doi

10.1530/EJE-19-0463

subject

Has Abstract

pub_date

2019-11-01 00:00:00

eissn

0804-4643

issn

1479-683X

pii

EJE-19-0463.R2

pub_type

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Safety and rapid efficacy of guideline-based gender affirming hormone therapy: an analysis of 388 individuals diagnosed with gender dysphoria.