A European Network for the Investigation of Gender Incongruence: Endocrine Part

Dekker, Marieke; Wierckx, Katrien; Caenegem, Eva Van; Klaver, Maartje; Kreukels, Baudewijntje P.C.; Elaut, Els; Fisher, Alessandra D.; Trotsenburg, M.A.A. van; Schreiner, Thomas; Heijer, Martin den; T’Sjoen, Guy

doi:10.1016/j.jsxm.2016.03.371

Cited by 109 publications

(102 citation statements)

References 20 publications

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“…The ENIGI collaboration started at 4 clinical centers in Amsterdam, Netherlands; Ghent, Belgium; Hamburg, Germany; and Oslo, Norway (125,126). More recently, ENIGI was expanded by including a fifth center in Florence, Italy (127). The ENIGI collaboration now uses the same diagnostic and psychological assessment battery and a common hormone treatment protocol.…”

Section: Discussionmentioning

confidence: 99%

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Cancer in Transgender People: Evidence and Methodological Considerations

Braun

Nash

Tangpricha

et al. 2017

Epidemiologic Reviews

168

122

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Transgender people comprise a diverse group of individuals whose gender identity or expression differs from that originally assigned to them at birth. Some, but not all, transgender people elect to undergo medical gender affirmation, which may include therapy with cross-sex hormones and/or surgical change of the genitalia and other sex characteristics. As cross-sex hormones administered for the purposes of gender affirmation may be delivered at high doses and over a period of decades, the carcinogenicity of hormonal therapy in transgender people is an area of considerable concern. In addition, concerns about cancer risk in transgender patients have been linked to sexually transmitted infections, increased exposure to well-known risk factors such as smoking and alcohol use, and the lack of adequate access to screening. Several publications have identified cancer as an important priority in transgender health research and called for large-scale studies. The goals of this article are to summarize the evidence on factors that may differentially affect cancer risk in transgender people, assess the relevant cancer surveillance and epidemiologic data available to date, and offer an overview of possible methodological considerations for future studies investigating cancer incidence and mortality in this population.

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Section: Discussionmentioning

confidence: 99%

“…This enhances the comparable collection of data and biological samples and will enable a wide range of studies evaluating treatment effectiveness and health outcomes. So far, the ENIGI endocrine data collection protocol enrolled 333 transwomen and 343 transmen (127), but the work is ongoing.…”

Section: Discussionmentioning

confidence: 99%

Cancer in Transgender People: Evidence and Methodological Considerations

Braun

Nash

Tangpricha

et al. 2017

Epidemiologic Reviews

168

122

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“…This study was part of the European Network for the Investigation of Gender Incongruence (ENIGI). ENIGI is a partnership of currently four European gender identity clinics in Amsterdam (the Netherlands), Ghent (Belgium), Oslo (Norway) and Florence (Italy) and was raised to obtain more transparency in diagnostics and treatment of transgender persons (Dekker et al., ; Kreukels et al., ). Because long‐term prolactin data were not available in this prospective population, we added a retrospective (post‐SRS) population to examine these levels.…”

Section: Methodsmentioning

confidence: 99%

Prolactin levels during short- and long-term cross-sex hormone treatment: an observational study in transgender persons

et al. 2016

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The cause of prolactin alterations in transgender persons is often assigned to oestrogens, but the precise cause and time course during different phases of cross-sex hormone treatment (CHT) remain unclear. In this study, we prospectively examined prolactin levels in 55 female-to-males (FtMs) and 61 male-to-females (MtFs) during the first year of CHT. Because long-term prolactin data were not available in this population, we studied these levels in a retrospective population of 25 FtMs and 38 MtFs who underwent gonadectomy. FtMs were treated with testosterone and MtFs with estradiol, with or without the anti-androgen cyproterone acetate (CPA) (after gonadectomy CPA is cessated). During the first year of CHT, prolactin decreased with 25% (95CI: -33%, -12%) in FtMs and increased with 193% (95CI: 156%, 219%) in MtFs. Eighteen MtFs developed hyperprolactinemia (≥0.6 IU L ). In the retrospective population, post-gonadectomy levels in FtMs were lower than baseline levels (-39%; 95CI: -51%, -20%) while in MtFs post-gonadectomy levels and baseline levels were comparable (-6%; 95CI: -24%, 15%). No hyperprolactinemia was found after gonadectomy. In conclusion, in FtMs, prolactin decreased consistently during CHT and in MtFs, prolactin increased during pre-surgical CHT but normalised after gonadectomy. It is likely that CPA induces increasing prolactin levels in MtFs.

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“…16–23 Most of the available data used to address the mental health status of TGNC youth come from specialized clinics providing care to this population. 24 Although researchers in clinicbased studies offer detailed and high-quality data, 25, 26 they often lack information on individuals who have not sought or had no access to specialized care. Moreover, a reliance on specialized clinics to identify study participants may yield relatively small sample sizes, making it difficult to select comparable reference groups from the same underlying population.…”

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confidence: 99%

Mental Health of Transgender and Gender Nonconforming Youth Compared With Their Peers

Liu²,

et al. 2018

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BACKGROUND Understanding the magnitude of mental health problems, particularly life-threatening ones, experienced by transgender and/or gender nonconforming (TGNC) youth can lead to improved management of these conditions. METHODS Electronic medical records were used to identify a cohort of 588 transfeminine and 745 transmasculine children (3–9 years old) and adolescents (10–17 years old) enrolled in integrated health care systems in California and Georgia. Ten male and 10 female referent cisgender enrollees were matched to each TGNC individual on year of birth, race and/or ethnicity, study site, and membership year of the index date (first evidence of gender nonconforming status). Prevalence ratios were calculated by dividing the proportion of TGNC individuals with a specific mental health diagnosis or diagnostic category by the corresponding proportion in each reference group by transfeminine and/or transmasculine status, age group, and time period before the index date. RESULTS Common diagnoses for children and adolescents were attention deficit disorders (transfeminine 15%; transmasculine 16%) and depressive disorders (transfeminine 49%; transmasculine 62%), respectively. For all diagnostic categories, prevalence was severalfold higher among TGNC youth than in matched reference groups. Prevalence ratios (95% confidence intervals [CIs]) for history of self-inflicted injury in adolescents 6 months before the index date ranged from 18 (95% CI 4.4–82) to 144 (95% CI 36–1248). The corresponding range for suicidal ideation was 25 (95% CI 14–45) to 54 (95% CI 18–218). CONCLUSIONS TGNC youth may present with mental health conditions requiring immediate evaluation and implementation of clinical, social, and educational gender identity support measures.

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A European Network for the Investigation of Gender Incongruence: Endocrine Part

Cited by 109 publications

References 20 publications

Cancer in Transgender People: Evidence and Methodological Considerations

Cancer in Transgender People: Evidence and Methodological Considerations

Prolactin levels during short- and long-term cross-sex hormone treatment: an observational study in transgender persons

Mental Health of Transgender and Gender Nonconforming Youth Compared With Their Peers

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