Testosterone GAHT is life changing, and increased research will help GAHT optimisation and improve understanding of tissue-specific impacts and long-term safety, though longer-term data and prospective studies are still needed.
Key Findings
Background
There has been a considerable increase in publications regarding testosterone GAHT in recent years, though narrative reviews, opinion pieces, and case series continue to dominate the literature.
The review covers updates from the last 18 months mainly in testosterone use in masculinising gender-affirming hormone therapy (GAHT) in postpubertal adults.
A notable increase in prospective studies and valuable data from large longitudinal cohorts has been observed.
Studies are increasingly aiming to refine GAHT prescribing and better understand long-term effects.
Results
Testosterone GAHT has documented long-term effects on fertility, cardiometabolic health, and bone health that require further study.
The review highlights fertility, cardiometabolic, and bone health as key areas where long-term effect data is being gathered.
Large longitudinal cohort studies are providing valuable data on these outcomes.
Adverse effects of testosterone GAHT are also an area of active investigation.
Background
Both testosterone for masculinising GAHT and antiandrogens for feminising GAHT are covered as distinct therapeutic categories in transgender medicine.
The review addresses testosterone use in masculinising GAHT for postpubertal adults.
Antiandrogens are used for suppression or blockade of endogenous testosterone in feminising GAHT.
Mental and sexual healthcare were identified as vital for many transgender patients but were explicitly excluded from the scope of this review.
Conclusions
Longer-term data, prospective studies, and novel research tools are identified as needed to enrich understanding and prescribing of testosterone and its blockers in GAHT.
Current literature is dominated by narrative reviews, opinion pieces, and case series rather than high-quality prospective or longitudinal data.
The authors call for utilisation of novel research tools and approaches.
GAHT optimisation and improved understanding of tissue-specific impacts and long-term safety are stated goals for future research.
Luo J, Upreti R. (2025). Current opinions invited review: testosterone and transgender medicine.. Current opinion in endocrinology, diabetes, and obesity. https://doi.org/10.1097/MED.0000000000000912