The ENIGI (European Network for the Investigation of Gender Incongruence) Study: Overview of Acquired Endocrine Knowledge and Future Perspectives

Cocchetti, Carlotta; Romani, Alessia; Collet, Sarah; Greenman, Yona; Schreiner, Thomas; Wiepjes, Chantal M.; Heijer, Martin den; T’Sjoen, Guy; Fisher, Alessandra D.

doi:10.3390/jcm11071784

Cited by 21 publications

(17 citation statements)

References 48 publications

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“…Hormonal therapy for transgender females entails possible risks of thromboembolic disease, liver dysfunction, hypertension, and hypertriglyceridemia. Hence, regular clinical evaluation and laboratory monitoring are recommended [ 21 , 24 ]. There is a theoretical possibility that cross-sex treatment could induce hormone-sensitive malignancies, especially after an extended period of use.…”

Section: Caring For Transgender Peoplementioning

confidence: 99%

Glucose Homeostasis, Diabetes Mellitus, and Gender-Affirming Treatment

et al. 2023

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The transgender (trans) population includes individuals with gender identities more fittingly aligned with the opposite sex or with an alternative that transcends the classical dipole of male/female. Hormonal treatment in transgender individuals aims to suppress the secretion of endogenous sex steroids and replace them with the steroids of the desired gender. The mainstay of gender-affirming treatment in transgender males is testosterone, whereas for transgender females it is estrogen, usually combined with an anti-androgen or a gonadotropin-releasing hormone agonist if testes are present. Testosterone and estrogen are involved in carbohydrate metabolism via direct effects on skeletal muscle, liver, adipose tissue, and immune cells and indirectly through changes in body fat mass and distribution. The effect of transgender treatment on glucose tolerance is not clear. The provided conflicting results demonstrate a positive, neutral, or even negative association between exogenous testosterone and insulin sensitivity in trans men. Studies show that feminizing hormonal therapy of trans women has mainly an aggravating effect on insulin sensitivity. The existing evidence is not robust and further research is needed to investigate the relationships between body fat distributions, muscle mass, and glycemia/insulin resistance in transgender people under hormonal therapy.

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Section: Caring For Transgender Peoplementioning

confidence: 99%

Glucose Homeostasis, Diabetes Mellitus, and Gender-Affirming Treatment

et al. 2023

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“…Insulin Resistance A systematic review of estrogen therapy in transgender women reported that 5 of 8 studies included showed increased insulin resistance, with 3 finding no effect. 11 , 21 Another study showed that insulin sensitivity and incretin responses after an oral glucose tolerance test decreased with estrogen treatment. 11 Finally, transgender women have been reported to be more insulin resistant than cisgender men (mean [±SD] 0.078±0.025 vs. 0.142±0.064 mL/μU; P=0.011).…”

Section: Transgender Womenmentioning

confidence: 99%

“… 11 , 21 Another study showed that insulin sensitivity and incretin responses after an oral glucose tolerance test decreased with estrogen treatment. 11 Finally, transgender women have been reported to be more insulin resistant than cisgender men (mean [±SD] 0.078±0.025 vs. 0.142±0.064 mL/μU; P=0.011).…”

Section: Transgender Womenmentioning

confidence: 99%

Cardiovascular Risk in Transgender People With Gender-Affirming Hormone Treatment

Masumori

Nakatsuka

2023

Circ Rep

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Gender-affirming hormone treatment generally by cross-sex hormones is an important strategy for transgender people to achieve the physical features affirming their experienced gender. Estrogens and androgens are administrated, usually for a long time, to transgender women and transgender men who would like to physically achieve feminization and masculinization, respectively. Several harmful adverse events have been reported in the literature following the administration of gender-affirming hormones, including worsening of lipid profiles and cardiovascular events (CVE) such as venous thromboembolism, stroke, and myocardial infarction, but it remains unknown whether the administration of cross-sex hormones to transgender people increases the subsequent risk of CVE and death. Based on the findings of the present narrative review of the recent literature, including meta-analyses and relatively large-scale cohort studies, it is likely that estrogen administration increases the risk of CVE in transgender women, but it remains inconclusive as to whether androgen administration increases the risk of CVE in transgender men. Thus, definitive evidence guaranteeing the long-term safety of cross-sex hormone treatment on the cardiovascular system is insufficient because of lack of evidence from well-organized, high-quality, and large-scale studies. In this situation, as well as considering the proper use of cross-sex hormones, pretreatment screening, regular medical monitoring, and appropriate intervention for risk factors of CVE are necessary to maintain and improve the health of transgender people.

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“…Including people who self-administer would be a leap forward in breaking down these research walls, by including a broader spectrum of people taking gender affirming hormonal therapy and thus creating larger databases. Comparing their data on first encounter to those of study participants with similar duration of prescribed hormone treatment within a provided context (such as the European Network for the Investigation of Gender Incongruence 27 ) will elucidate differences in safety and effectiveness. Psychosocial variables must also be included in this type of research.…”

Section: Doing Bettermentioning

confidence: 99%