Endocrine Care of Transgender Adults

Fishman, Sarah L.; Paliou, Maria; Poretsky, Leonid; Hembree, Wylie C.

doi:10.1007/978-3-030-05683-4_8

Cited by 4 publications

(2 citation statements)

References 123 publications

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“…2 Previous studies have proven the benefit of gender-affirming hormonal and surgical care in reducing or even resolving feelings of gender dysphoria in transgender people, 3e14 with limited effects on long-term mortality and morbidity. 15 However, sexual health may be impaired in transgender people because of gender dysphoria, fear of disclosing the transgender identity, fear of stigmatization and rejection, objectification, transphobia, prejudice, discrimination, targeted victimization, being treated in a disrespectful way, not being able to access transgender care, desire for future interventions, experiencing sexual violence or as a side effect of gender-affirming care (HT or gonadectomy). 16e19 Therefore, it is important to inquire about sexuality, not only as a mental health professional but also as a surgeon or hormoneprescribing physician.…”

Section: Introductionmentioning

confidence: 99%

Sexual Desire Changes in Transgender Individuals Upon Initiation of Hormone Treatment: Results From the Longitudinal European Network for the Investigation of Gender Incongruence

Defreyne

Elaut

Kreukels

et al. 2020

The Journal of Sexual Medicine

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Introduction Several steps in the transitioning process may affect sexual desire in transgender people. This is often underexposed by those providing gender-affirming care. Aim To prospectively assess sexual desire during the first 3 years of hormonal therapy (HT) in transgender people. Methods This prospective cohort study was part of the European Network for the Investigation of Gender Incongruence. At baseline, different psychological questionnaires were administered. Sex steroids were measured at each follow-up visit. Data were analyzed cross-sectionally and prospectively. Main Outcome Measure Prospective analysis of total, dyadic (with another person), and solitary (with oneself) sexual desire in 766 participants (401 transgender women [TW], 364 transgender men [TM]) was carried out using the Sexual Desire Inventory (SDI) questionnaire during a 3-year follow-up period, starting at the initiation of HT. Other factors associated with prospective changes were assessed. Results In TW, total, dyadic, and solitary SDI scores decreased during the first 3 months of HT. However, after 36 months, total and dyadic SDI scores were higher than baseline scores. Solitary scores after 36 months were comparable with baseline scores. In TM, total, dyadic, and solitary SDI scores increased over the first 3 months, remaining stable thereafter. However, total and dyadic SDI scores after 36 months were comparable with baseline scores, whereas solitary scores remained higher than baseline. Factors associated with a prospective increase in SDI scores included having undergone gonadectomy, no longer experiencing menstrual bleeding or higher gender dysphoria levels at baseline (in TM only). Clinical Implications This study offers clear data on the time course of sexual desire after starting HT and thereby helps to inform people who want to start HT. Transgender people can be informed that changes in sexual desire after initiating HT are temporary. Over a longer period of time, the current research does not suggest induction of hypoactive sexual disorder in TW or long-term increased sexual desire in TM. Strength & Limitations Strengths include the prospective design of this large multicentric study, the well-defined cohort, controlling for HT, sex steroids, and other factors. Limitations include performing a data lock, the absence of an objective measure of sexual desire, and the timing of laboratory measurements. Conclusion Gender-affirming HT only induces short-term changes in sexual desire in transgender people. Over a longer period of time, a net increase in dyadic sexual desire in TW receiving feminizing HT and sexual desire scores comparable with baseline in TM receiving virilizing HT, were observed.

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Section: Introductionmentioning

confidence: 99%

Sexual Desire Changes in Transgender Individuals Upon Initiation of Hormone Treatment: Results From the Longitudinal European Network for the Investigation of Gender Incongruence

Defreyne

Elaut

Kreukels

et al. 2020

The Journal of Sexual Medicine

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“…GAHT is associated with increased risk of VTE in transgender women. Oral ethinyl estradiol is now less commonly prescribed due to this recognized higher risk, with micronized estradiol and estradiol valerate now the preferred forms of oral estrogen [ 42 ]. To the best of our knowledge, no study had demonstrated increased risk of VTE in transgender men receiving GAHT.…”

Section: Discussionmentioning

confidence: 99%

The effects of gender-affirming hormone therapy on cardiovascular and skeletal health: A literature review

et al. 2022

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A Mouse Model to Investigate the Impact of Gender Affirming Hormone Therapy with Estradiol on Reproduction

Pfau,

Schwartz,

Dela Cruz

et al. 2023

Advanced Biology

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Gender‐affirming hormone therapy (GAHT) can help transgender and/or gender diverse (TGD) individuals achieve emobidment goals that align with their transition needs. Clinical evidence from estradiol (E)‐GAHT patients indicate widespread changes in tissues sensitive to E and testosterone (T), particularly in the reproductive system. Notably, E‐GAHTs effects on hormones and reproduction vary greatly between patients. With the goal of informing clinical research and practice for TGD individuals taking E, this study examines intact male mice implanted with capsules containing one of three different E doses (low 1.25 mg; mid 2.5 mg; high 5 mg), or a blank control capsule. All E‐GAHT doses suppress T and follicle stimulating hormone levels while elevating E levels. Only the high E‐GAHT dose significantly supresses luteinizing hormone levels. All E‐GAHT doses affect epididymis tubule size similarly while seminiferous tubule morphology and bladder weight changes are dose‐dependent. E‐GAHT does not alter the presence of mature sperm, though E‐exposed sperm have altered motility. These data represent the first evidence that mouse models offer an effective tool to understand E‐GAHTs impact on reproductive health and the dose‐dependent effects of this model permit examinations of diverse patient outcomes.

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Endocrine Care of Transgender Adults

Cited by 4 publications

References 123 publications

Sexual Desire Changes in Transgender Individuals Upon Initiation of Hormone Treatment: Results From the Longitudinal European Network for the Investigation of Gender Incongruence

Sexual Desire Changes in Transgender Individuals Upon Initiation of Hormone Treatment: Results From the Longitudinal European Network for the Investigation of Gender Incongruence

The effects of gender-affirming hormone therapy on cardiovascular and skeletal health: A literature review

A Mouse Model to Investigate the Impact of Gender Affirming Hormone Therapy with Estradiol on Reproduction

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