Most transgender and gender diverse patients achieve target testosterone levels within 9 months of GAHT initiation, and adverse effects of GAHT are rare and usually mild.
Key Findings
Results
The majority of transmasculine individuals achieved therapeutic testosterone levels within 9 months of GAHT initiation.
116 of 154 transmasculine individuals (75%) achieved a testosterone level >10 nmol/L during follow-up.
The median time to achieve therapeutic testosterone concentrations was 4 months (IQR 4-9).
No clinical or biochemical factors were significantly associated with likelihood of reaching therapeutic testosterone concentrations in transmen.
Results
The majority of transfeminine individuals achieved testosterone suppression to target levels within 9 months of GAHT initiation.
131 of 191 transfeminine individuals (72%) achieved a testosterone level <2.0 nmol/L during follow-up.
The median time to achieve testosterone suppression was 4 months (IQR 3-9).
Factors associated with increased likelihood of testosterone suppression included use of subdermal estradiol implants and cyproterone acetate as an androgen antagonist.
Results
GAHT produced changes in lipids, liver function, and blood count that differed in direction between transmasculine and transfeminine individuals.
Changes in differing directions were observed during repeated measures of lipids, liver function, and blood count between transmasculine and transfeminine individuals.
These changes reflect the important effects of testosterone and estradiol on biochemical tests ordered as part of routine clinical care.
The study used repeated measures analysis to assess these biochemical variables.
Results
Adverse effects of GAHT were rare and usually mild in this cohort of 345 TGD patients.
The total cohort included 345 patients (154 transmasculine and 191 transfeminine individuals).
The study was a retrospective cohort study of outcomes in transgender and gender diverse patients starting GAHT.
Adverse effects of GAHT are described as rare and usually mild.
Methods
The primary outcome of the study was the proportion of patients and time required to achieve optimal hormone levels after commencement of GAHT.
Additional analyses assessed whether clinical and biochemical factors were associated with likelihood of achieving target hormone levels.
Target testosterone level for transmasculine individuals was defined as >10 nmol/L.
Target testosterone level for transfeminine individuals was defined as <2.0 nmol/L.
The study design was a retrospective cohort study.
Muir C, Guttman-Jones M, Man E. (2024). Effects of gender affirming hormone treatment in transgender individuals - a retrospective cohort study.. Endocrine. https://doi.org/10.1007/s12020-024-03736-0