Interpreting Laboratory Results in Transgender Patients on Hormone Therapy
Abstract
Background Clinical guidelines recommend laboratory monitoring of transgender persons on cross-sex hormone therapy, but gender-specific reference intervals leave clinicians with the dilemma of deciding what is "normal" for each patient. The goal of this study was to identify consistent changes in measurands with hormone therapy and determine which reference interval is appropriate.Methods Laboratory data were abstracted from the medical records of 55 male-to-female patients on hormone therapy and compared with 20 male and 20 female nontransgender subjects.Results Hemoglobin, hematocrit, and low-density lipoprotein resembled female values (P < .005), while alkaline phosphatase, potassium, and creatinine resembled male values (P < .05). Triglycerides were higher (P < .005) than either the male or female groups. The remainder of the measurands showed no differences.Conclusions Use of correct reference intervals in interpreting laboratory results reduces the risk of testing-related diagnostic error. Preliminary data suggest that new reference intervals need to be established for transgender patients.
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Two cross-sectional studies found that transwomen on GAHT for 6 or 48 months had lower (10%) HCT than cisgender men (p<0.005).
“Two studies found that transwomen on GAHT for 6 or 48 months had lower (10%) HCT than cisgender men53 54 (p<0.005)”
Two cross-sectional studies found no difference in HCT between transwomen after 6 and 12 months of GAHT and cisgender women.
“while two studies found no difference between transwomen after 6 and 12 months of GAHT and cisgender women.18 53”
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- Authors
- Roberts, T. K., Kraft, C. S., French, D., Ji, W., Wu, A. H. B., Tangpricha, V., & Fantz, C. R.
- Affiliations
- Emory University (US)
- University of California, San Francisco (US)
- San Francisco General Hospital (US)
- Corresponding author
- Roberts, Tiffany K.
- Venue
- The American Journal of Medicine
- Publisher
- Elsevier BV
- Published
- 2014-02
- Volume
- 127
- Issue
- 2
- Pages
- 159-162
- ISSN
- 0002-9343 (ISSN-L)
- OpenAlex
- W2002613869
- Cited by
- 109
- References
- 13
- Citations by year
- 2026: 4 · 2025: 6 · 2024: 11 · 2023: 12 · 2022: 11 · 2021: 8 · 2020: 13 · 2019: 10 · 2018: 8 · 2017: 17 · 2016: 5 · 2015: 3 · 2014: 1
- FWCI
- 2.08
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The American Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Clinical Laboratory Practices and Quality Control
- Social Sciences › Psychology › Social Psychology › LGBTQ Health, Identity, and Policy
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
- Keywords
- transgender patients, gender-affirming hormone therapy, laboratory reference intervals, laboratory monitoring, hemoglobin, hematocrit, low-density lipoprotein, alkaline phosphatase, triglycerides, diagnostic errors
- MeSH terms
- Adult, Aged, Alkaline Phosphatase, Creatinine, Diagnostic Errors, Female, Hematocrit, Hemoglobins, Humans, Cholesterol, LDL, Male, Middle Aged, Potassium, Reference Values, Gonadal Steroid Hormones, Triglycerides, Biomarkers, Gender-Affirming Procedures, Transgender Persons
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