Biochemical Changes During the First Year of Feminizing Hormone Therapy in Transfeminine Individuals

Background: Persons with assigned male sex at birth (AMAB) might wish to obtain feminization and/or demasculinization according to the person's gender identity and are therefore treated with estradiol and/or antiandrogens. Aim: The aim was to evaluate biochemical changes and side effects in AMA...

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Main Authors: Johanne Andersen Hojbjerg, MD, PhD, Astrid Ditte Højgaard, MD, Anne-Mette Hvas, MD, PhD
Format: Article
Language:English
Published: Oxford University Press 2022-02-01
Series:Sexual Medicine
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2050116121001525
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author Johanne Andersen Hojbjerg, MD, PhD
Astrid Ditte Højgaard, MD
Anne-Mette Hvas, MD, PhD
author_facet Johanne Andersen Hojbjerg, MD, PhD
Astrid Ditte Højgaard, MD
Anne-Mette Hvas, MD, PhD
author_sort Johanne Andersen Hojbjerg, MD, PhD
collection DOAJ
description Background: Persons with assigned male sex at birth (AMAB) might wish to obtain feminization and/or demasculinization according to the person's gender identity and are therefore treated with estradiol and/or antiandrogens. Aim: The aim was to evaluate biochemical changes and side effects in AMAB individuals treated with guideline-based feminizing hormone treatment (FHT). Methods: Medical charts of 99 AMAB individuals ≥ 18 years referred to the Center for Gender Identity; Aalborg University hospital, Denmark, between January 2017 and July 2019 were reviewed to identify adverse side effects. Furthermore, data from the laboratory information system (Labka II) were retrieved to obtain biochemical parameters. Biochemical plasma concentrations after initiation of FHT were compared to concentrations prior to FHT and to existing guidelines. Outcomes: After 11–19 months, 29% of the trans feminine individuals had plasma estradiol concentrations within the treatment target. Results: The plasma concentration of estradiol varies greatly during FHT. Plasma levels of estrogen were within the treatment target after 11–19 months of treatment, whereas 100% had concentrations within the reference range for premenopausal cis-women. Furthermore, plasma concentrations of lipids and hematological parameters approached female reference ranges after 11 months of FHT. Clinical Implications: The target levels of plasma estradiol concentrations during FHT could be expanded, making the wanted physiological changes easier to obtain. Strengths & Limitation: This cohort study included 99 AMAB individuals and biochemical evaluation was possible in 67 individuals. Only one individual was lost during follow-up. However, the follow-up period was limited making evaluation of long-term side effects impossible. Conclusion: Plasma concentration of estradiol varies greatly during guideline based FHT, making plasma estradiol levels within the target level difficult to attain.JA Hojbjerg, AD Højgaard, A-M Hvas. Biochemical Changes During the First Year of Feminizing Hormone Therapy in Transfeminine Individuals. Sex Med 2021;10:100472.
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spelling doaj.art-0841207f72b3466eb9565f4e5a312e0f2023-09-02T04:23:17ZengOxford University PressSexual Medicine2050-11612022-02-01101100472Biochemical Changes During the First Year of Feminizing Hormone Therapy in Transfeminine IndividualsJohanne Andersen Hojbjerg, MD, PhD0Astrid Ditte Højgaard, MD1Anne-Mette Hvas, MD, PhD2Aalborg University Hospital, Department of Clinical Biochemistry, Aalborg, Denmark; Aarhus University Hospital, Department of Clinical Biochemistry, Aarhus, Denmark; Corresponding Author: Johanne Andersen Hojbjerg, MD, PhD, Palle Juul-Jensens Boulevard, 99DK-8200 Aarhus, DenmarkAalborg University Hospital, Sexological Center, Aalborg, Denmark; Aalborg University, Clinical Institute, Aalborg, DenmarkAarhus University Hospital, Department of Clinical Biochemistry, Aarhus, Denmark; Aarhus University, Department of Clinical Medicine, Aarhus, DenmarkBackground: Persons with assigned male sex at birth (AMAB) might wish to obtain feminization and/or demasculinization according to the person's gender identity and are therefore treated with estradiol and/or antiandrogens. Aim: The aim was to evaluate biochemical changes and side effects in AMAB individuals treated with guideline-based feminizing hormone treatment (FHT). Methods: Medical charts of 99 AMAB individuals ≥ 18 years referred to the Center for Gender Identity; Aalborg University hospital, Denmark, between January 2017 and July 2019 were reviewed to identify adverse side effects. Furthermore, data from the laboratory information system (Labka II) were retrieved to obtain biochemical parameters. Biochemical plasma concentrations after initiation of FHT were compared to concentrations prior to FHT and to existing guidelines. Outcomes: After 11–19 months, 29% of the trans feminine individuals had plasma estradiol concentrations within the treatment target. Results: The plasma concentration of estradiol varies greatly during FHT. Plasma levels of estrogen were within the treatment target after 11–19 months of treatment, whereas 100% had concentrations within the reference range for premenopausal cis-women. Furthermore, plasma concentrations of lipids and hematological parameters approached female reference ranges after 11 months of FHT. Clinical Implications: The target levels of plasma estradiol concentrations during FHT could be expanded, making the wanted physiological changes easier to obtain. Strengths & Limitation: This cohort study included 99 AMAB individuals and biochemical evaluation was possible in 67 individuals. Only one individual was lost during follow-up. However, the follow-up period was limited making evaluation of long-term side effects impossible. Conclusion: Plasma concentration of estradiol varies greatly during guideline based FHT, making plasma estradiol levels within the target level difficult to attain.JA Hojbjerg, AD Højgaard, A-M Hvas. Biochemical Changes During the First Year of Feminizing Hormone Therapy in Transfeminine Individuals. Sex Med 2021;10:100472.http://www.sciencedirect.com/science/article/pii/S2050116121001525Gender DysphoriaSexual and Gender DisordersGender Identity
spellingShingle Johanne Andersen Hojbjerg, MD, PhD
Astrid Ditte Højgaard, MD
Anne-Mette Hvas, MD, PhD
Biochemical Changes During the First Year of Feminizing Hormone Therapy in Transfeminine Individuals
Sexual Medicine
Gender Dysphoria
Sexual and Gender Disorders
Gender Identity
title Biochemical Changes During the First Year of Feminizing Hormone Therapy in Transfeminine Individuals
title_full Biochemical Changes During the First Year of Feminizing Hormone Therapy in Transfeminine Individuals
title_fullStr Biochemical Changes During the First Year of Feminizing Hormone Therapy in Transfeminine Individuals
title_full_unstemmed Biochemical Changes During the First Year of Feminizing Hormone Therapy in Transfeminine Individuals
title_short Biochemical Changes During the First Year of Feminizing Hormone Therapy in Transfeminine Individuals
title_sort biochemical changes during the first year of feminizing hormone therapy in transfeminine individuals
topic Gender Dysphoria
Sexual and Gender Disorders
Gender Identity
url http://www.sciencedirect.com/science/article/pii/S2050116121001525
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