A Review of Animal Models Investigating the Reproductive Effects of Gender-Affirming Hormone Therapy
Gender-affirming hormone therapy (GAHT) is an important component in the process of transitioning for many transgender and gender-diverse (TGD) individuals. Multiple medical organizations recommend fertility preservation counseling prior to initiation of GAHT; however, there remains little high-qual...
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| Format: | Article |
| Language: | English |
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MDPI AG
2024-02-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/13/4/1183 |
| _version_ | 1797297831937048576 |
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| author | Nicholas S. Raja Elizabeth S. Rubin Molly B. Moravek |
| author_facet | Nicholas S. Raja Elizabeth S. Rubin Molly B. Moravek |
| author_sort | Nicholas S. Raja |
| collection | DOAJ |
| description | Gender-affirming hormone therapy (GAHT) is an important component in the process of transitioning for many transgender and gender-diverse (TGD) individuals. Multiple medical organizations recommend fertility preservation counseling prior to initiation of GAHT; however, there remains little high-quality data regarding the impact of GAHT on fertility and reproductive function. A PubMed literature review was performed using Boolean search operators linking keywords or phrases such as “mouse”, “rat”, “primate”, “animal model”, “transgender”, “gender”, “estrogen”, “testosterone”, “fertility”, and “fertility preservation”. Recent research has produced a number of animal models of GAHT that utilize similar hormonal regimens and produce similar phenotypic results to those used and observed in human patients. Specific to testosterone(T)-containing GAHT, animals demonstrate loss of menstrual cyclicity with therapy, resumption of menses on cessation of therapy, suppression of gonadotropin levels, and physical changes such as clitoromegaly. Models mimicking GAHT for transmasculine individuals in the peripubertal period demonstrate that pretreatment with GnRHa therapy does not modify the effects of subsequent T administration, which were similar to those described in adult models. Both models suggest promising potential for future fertility with cessation of T. With estradiol (E)-containing GAHT, animals exhibit decreased size of testicles, epididymis, and seminal vesicles, as well as ongoing production of spermatocytes, and seminiferous tubule vacuolization. Given the ethical challenges of conducting human studies in this area, high-fidelity animal models represent a promising opportunity for investigation and could eventually transform clinical counseling about the necessity of fertility preservation. Future studies should better delineate the interactions (if any exist) between treatment attributes such as dosing and duration with the extent of reversibility of reproductive perturbations. The development of models of peripubertal feminizing GAHT is an additional area for future work. |
| first_indexed | 2024-03-07T22:27:01Z |
| format | Article |
| id | doaj.art-c6dc354e0eaa482dba55a9221a6ed8d8 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-07T22:27:01Z |
| publishDate | 2024-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-c6dc354e0eaa482dba55a9221a6ed8d82024-02-23T15:22:32ZengMDPI AGJournal of Clinical Medicine2077-03832024-02-01134118310.3390/jcm13041183A Review of Animal Models Investigating the Reproductive Effects of Gender-Affirming Hormone TherapyNicholas S. Raja0Elizabeth S. Rubin1Molly B. Moravek2Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI 48109, USADepartment of Obstetrics and Gynecology, Oregon Health & Science University, Portland, OR 97239, USADepartment of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI 48109, USAGender-affirming hormone therapy (GAHT) is an important component in the process of transitioning for many transgender and gender-diverse (TGD) individuals. Multiple medical organizations recommend fertility preservation counseling prior to initiation of GAHT; however, there remains little high-quality data regarding the impact of GAHT on fertility and reproductive function. A PubMed literature review was performed using Boolean search operators linking keywords or phrases such as “mouse”, “rat”, “primate”, “animal model”, “transgender”, “gender”, “estrogen”, “testosterone”, “fertility”, and “fertility preservation”. Recent research has produced a number of animal models of GAHT that utilize similar hormonal regimens and produce similar phenotypic results to those used and observed in human patients. Specific to testosterone(T)-containing GAHT, animals demonstrate loss of menstrual cyclicity with therapy, resumption of menses on cessation of therapy, suppression of gonadotropin levels, and physical changes such as clitoromegaly. Models mimicking GAHT for transmasculine individuals in the peripubertal period demonstrate that pretreatment with GnRHa therapy does not modify the effects of subsequent T administration, which were similar to those described in adult models. Both models suggest promising potential for future fertility with cessation of T. With estradiol (E)-containing GAHT, animals exhibit decreased size of testicles, epididymis, and seminal vesicles, as well as ongoing production of spermatocytes, and seminiferous tubule vacuolization. Given the ethical challenges of conducting human studies in this area, high-fidelity animal models represent a promising opportunity for investigation and could eventually transform clinical counseling about the necessity of fertility preservation. Future studies should better delineate the interactions (if any exist) between treatment attributes such as dosing and duration with the extent of reversibility of reproductive perturbations. The development of models of peripubertal feminizing GAHT is an additional area for future work.https://www.mdpi.com/2077-0383/13/4/1183animal modelsgender-affirming hormone therapytransgenderreproductionfertility preservation |
| spellingShingle | Nicholas S. Raja Elizabeth S. Rubin Molly B. Moravek A Review of Animal Models Investigating the Reproductive Effects of Gender-Affirming Hormone Therapy Journal of Clinical Medicine animal models gender-affirming hormone therapy transgender reproduction fertility preservation |
| title | A Review of Animal Models Investigating the Reproductive Effects of Gender-Affirming Hormone Therapy |
| title_full | A Review of Animal Models Investigating the Reproductive Effects of Gender-Affirming Hormone Therapy |
| title_fullStr | A Review of Animal Models Investigating the Reproductive Effects of Gender-Affirming Hormone Therapy |
| title_full_unstemmed | A Review of Animal Models Investigating the Reproductive Effects of Gender-Affirming Hormone Therapy |
| title_short | A Review of Animal Models Investigating the Reproductive Effects of Gender-Affirming Hormone Therapy |
| title_sort | review of animal models investigating the reproductive effects of gender affirming hormone therapy |
| topic | animal models gender-affirming hormone therapy transgender reproduction fertility preservation |
| url | https://www.mdpi.com/2077-0383/13/4/1183 |
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