The Impact of Hormone Therapy on Inflammatory Bowel Disease in Transgender and Nonbinary Individuals.

GAHT was not associated with an increased incidence of IBD flares in transgender and nonbinary individuals.

• The proportion of patients who flared after GAHT was similar to that before GAHT: 9 (60%) vs 8 (53.3%), P=1.0.
• Of 15 patients on HT, 8 (36.3%) experienced at least one flare.
• The study was a retrospective chart review conducted at Johns Hopkins Hospital from 2015 to 2022.
• 22 patients total were analyzed.

The study cohort was predominantly assigned female at birth and underwent masculinizing hormone therapy.

• More than half (59%) of patients were assigned female at birth, identified as transmen, and underwent masculinizing HT.
• The median (interquartile range) age was 30 (25-36) years.
• Median IBD duration was 6.2 (1.8-12.3) years.
• Nine (41%) patients were on biologics.

Crohn's disease was more prevalent than ulcerative colitis in the study cohort, though the difference was not statistically significant.

• 13 patients (59.1%) had Crohn's disease compared with 9 (40.9%) with ulcerative colitis.
• P=.23 for the comparison between Crohn's disease and ulcerative colitis prevalence.

Among patients who experienced flares after GAHT, the majority were treated with steroids and a substantial proportion required hospital or emergency room admission.

• Most patients who flared were treated with steroids (66.7%).
• 6 (40%) of flaring patients required hospital or emergency room admission.
• Of 15 patients on HT, 8 (36.3%) experienced at least one flare.

Prior to this study, there was no existing literature on the impact of exogenous hormone therapy on IBD in transgender and nonbinary individuals.

• Although the impact of gender-affirming hormone therapy on IBD severity has been studied in cisgender patients, there was no literature on the impact of exogenous hormone therapy in TGNB individuals prior to this study.
• IBD affects around 3 million people in the United States.
• The authors called for larger prospective randomized studies to confirm findings and understand the interaction between GAHT and IBD in TGNB individuals.