Hormone Therapy

Gender-affirming hormone treatment: friend or foe? Long-term follow-up of 755 transgender people.

TL;DR

Transgender AFAB people achieve hormone targets earlier and more frequently than transgender AMAB individuals, who may require more frequent check-ups to tailor feminizing GAHT and increase therapeutic adherence.

Key Findings

Transgender AFAB individuals reached therapeutic hormone goals in less time, with fewer visits, and fewer GAHT scheme adjustments compared to transgender AMAB individuals.

  • Time to reach therapeutic goals was significantly shorter in AFAB group (p = 0.002)
  • Fewer visits were required to reach goals in AFAB group (p = 0.006)
  • Fewer adjustments of GAHT scheme were needed in AFAB group (p = 0.024)
  • 302 transgender AFAB and 453 transgender AMAB were included in the study

Transgender AFAB individuals showed higher adherence to medical prescriptions compared to transgender AMAB individuals.

  • Adherence difference was statistically significant (p < 0.001)
  • This was assessed in a real-world clinical setting across two Italian Endocrinology Units (Turin and Modena)
  • Data were collected retrospectively from 2005 to 2022

No significantly increased rate of cardiovascular events was detected in either transgender AFAB or transgender AMAB groups.

  • Cardiovascular events were tracked as part of routinely collected clinical data
  • This finding applied to both AMAB and AFAB groups over a long-term follow-up period
  • The study included anthropometric and biochemical parameters, lifestyle habits, GAHT regime, and cardiovascular events as measured variables

The two groups had similar overall follow-up duration and number of clinic visits.

  • Follow-up duration was not significantly different between groups (p = 0.974)
  • Number of visits was not significantly different between groups (p = 0.384)
  • Total cohort consisted of 755 transgender individuals (302 AFAB and 453 AMAB)

The study was designed as a retrospective, longitudinal, observational, multicentre clinical study with individualized patient management.

  • Participants were recruited from two Endocrinology Units in Italy (Turin and Modena) between 2005 and 2022
  • Each subject was managed with 'specific and personalized follow-up depending on the clinical practice of the Centre'
  • All clinical data routinely collected were extracted, including anthropometric and biochemical parameters, lifestyle habits, GAHT regime, and cardiovascular events
  • Participants were categorized as transgender assigned-male-at-birth (AMAB) and assigned-female-at-birth (AFAB)

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Citation

Santi D, Spaggiari G, Marinelli L, Cacciani M, Scipio S, Bichiri A, et al.. (2024). Gender-affirming hormone treatment: friend or foe? Long-term follow-up of 755 transgender people.. Journal of endocrinological investigation. https://doi.org/10.1007/s40618-023-02220-2