Mp02-16 describing Trends in the Prostate of Transgender Women on Androgen Deprivation Hormone Therapy

Abstract

INTRODUCTION AND OBJECTIVE:The impact of genderaffirming androgen deprivation hormone therapy (HT) on the prostate of transgender females (TF) has not been well described. The aim of our study is to understand prostate characteristics on ultrasound in TF.METHODS: We retrospectively evaluated the charts of TF on medical or surgical androgen deprivation (AD) as part of their gender transition who had transrectal ultrasound (US) imaging of the prostate. Ultrasounds were performed using a 10-5 MHz biplane probe for surgical planning. Variables evaluated included age, body mass index (BMI), prostate size, PSA values, if present, and duration of hormonal therapy. We performed age-matched comparisons between our cohort, published literature, and an internal data set of cisgender male patients. Pearson's R, Student's T test, and one-way ANOVA with Tukey's HSD were performed for hypothesis testing.RESULTS: Between 2020 and 2022, 60 TF patients underwent prostate US. Demographics and findings are summarized in Table 1. There was no correlation in prostate size with duration of HT (DHT) or BMI. Older current age was associated with increased prostate size (R [0.58, p<0.001). Starting AD at a later age of hormone transition (AHT) was also associated with larger prostate size (R[0.59, p<0.001). When stratifying by age at hormone transition and current age, patients over age 50 had significantly larger prostates, compared to age groups <26 and 26-50 (p<0.01, Figure 1). Linear regression modeling both AHT and DHT as predictors of prostate size showed that AHT was about twice as impactful as DHT (R[0.68, p<0.001). We also noted that our cohort's prostate volumes were significantly smaller than known population means for patients under age 51 (p<0.001), and were smaller than an age-matched cis male cohort from the same institution (Table 1).CONCLUSIONS: TF, primarily after 50, have larger prostates despite ongoing HT. Duration of HT and BMI were not independently correlated to prostate size, but older age at hormone transition and current age were associated with larger prostate size. [1]