Hematology reference intervals for transgender adults on stable hormone therapy

Greene, Dina N.; McPherson, Gabrielle Winston; Rongitsch, Jessica; Imborek, Katherine L.; Schmidt, Robert L.; Humble, Robert M.; Nisly, Nicole; Dole, Nancy J.; Dane, Susan K.; Frerichs, Janice; Krasowski, Matthew D.

doi:10.1016/j.cca.2019.02.011

Cited by 61Clinical Laboratory Practices and Quality ControlLGBTQ Health, Identity, and PolicyHormonal and reproductive studies

Hematology reference intervals for transgender adults on stable hormone therapy

Greene, Dina N., McPherson, Gabrielle Winston, Rongitsch, Jessica, Imborek, Katherine L., Schmidt, Robert L., Humble, Robert M., Nisly, Nicole, Dole, Nancy J. +3 more·2019·Clinica Chimica Acta

DOI 10.1016/j.cca.2019.02.011

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Abstract

Background The complete blood count (CBC) is a cornerstone of patient care. Several of the normal values for the components of the CBC differ by sex and, therefore, male-specific and female-specific reference intervals are required to interpret these laboratory results. Transgender individuals are often prescribed hormone therapy to affirm their gender, with resulting serum hormone concentrations similar to those of cisgender individuals. Gender-specific reference intervals for transgender men and women have not been established for any laboratory measurements, including hematology. We established clinically relevant hematological reference intervals for transgender individuals receiving stable hormone therapy.Methods Healthy transgender individuals prescribed testosterone (n = 79) or estrogen (n = 93) for ≥12 months were recruited from internal medicine and primary care clinics that specialize in transgender medical care. Concentrations for hemoglobin, hematocrit, MCV, MCHC, and RDWCV, as well as counts for red cells, white cells, and platelets, were evaluated. Results were interpreted in reference to the overall distribution of values and relative to serum estradiol and total testosterone concentrations. Calculated reference intervals were compared to established cisgender reference intervals.Results Regardless of serum hormone concentration, individuals prescribed testosterone or estrogen had hematology parameters that were not clinically different from cisgender males and females, respectively.Conclusion The hematology parameters for transgender men and women receiving stable hormone therapy should be evaluated against the cisgender male and cisgender female reference ranges, respectively and does not require concurrent sex hormone analysis. Care providers can utilize this observation to aid in interpretation of hematology laboratory values for transgender people.

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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”
From How does hormone transition in transgender women change body composition, muscle strength and haemoglobin? Systematic review with a focus on the implications for sport participation (2021) · cites this paper as [18]

Standards of Care for the Health of Transsexual, Transgender, and Gender-Nonconforming People, Version 7
Coleman, E., Bockting, W. O., Botzer, M., Cohen‐Kettenis, P. T., Cuypere, G. D., Feldman, J., Fraser, L., Green, J., Knudson, G., Meyer, W. J., et al. (2012) · International Journal of Transgenderism · doi:10.1080/15532739.2011.700873 · Cited by 3,145 · see citing works
Endocrine treatment of gender-dysphoric/gender-incongruent persons: an Endocrine Society Clinical Practice Guideline.
Hembree, W. C., Cohen-Kettenis, P. T., Gooren, L., Hannema, S. E., Meyer, W. J., Murad, M. H., Rosenthal, S. M., Safer, J. D., Tangpricha, V., & T’Sjoen, G. G. (2017) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2017-01658 · Cited by 2,328 · see citing works
Transgender people: health at the margins of society
Winter, S., Diamond, M., Green, J., Karasic, D. H., Reed, T., Whittle, S., & Wylie, K. R. (2016) · The Lancet · doi:10.1016/s0140-6736(16)00683-8 · Cited by 1,172 · see citing works
The sex difference in haemoglobin levels in adults—mechanisms, causes, and consequences
Murphy, W. G. (2014) · Blood Reviews · doi:10.1016/j.blre.2013.12.003 · Cited by 463 · see citing works
Reference change values
Fraser, C. G. (2012) · Clinical Chemistry and Laboratory Medicine · doi:10.1515/cclm.2011.733 · Cited by 286 · see citing works
Testosterone therapy for transgender men
Irwig, M. S. (2017) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(16)00036-x · Cited by 272 · see citing works
Low Testosterone Levels and the Risk of Anemia in Older Men and Women
Ferrucci, L., Maggio, M. G., Bandinelli, S., Basaria, S. S., Lauretani, F., Blè, A., Valenti, G., Ershler, W. B., Guralnik, J. M., & Longo, D. L. (2006) · Archives of Internal Medicine · doi:10.1001/archinte.166.13.1380 · Cited by 271 · see citing works
Complex Biological Profile of Hematologic Markers across Pediatric, Adult, and Geriatric Ages: Establishment of Robust Pediatric and Adult Reference Intervals on the Basis of the Canadian Health Measures Survey
Adeli, K., Raizman, J. E., Chen, Y., Higgins, V., Nieuwesteeg, M., Abdelhaleem, M. M., Wong, S. L., & Blais, D. R. (2015) · Clinical Chemistry · doi:10.1373/clinchem.2015.240531 · Cited by 185 · see citing works
Short- and Long-Term Clinical Skin Effects of Testosterone Treatment in Trans Men
Wierckx, K., de Peer, F. V., Verhaeghe, E., Dedecker, D., Caenegem, E. V., Toye, K. R. C., Kaufman, J., & T'Sjoen, G. G. (2013) · The Journal of Sexual Medicine · doi:10.1111/jsm.12366 · Cited by 160 · see citing works
Prospective evaluation of hematocrit in gender-affirming hormone treatment: results from European network for the investigation of gender incongruence
Defreyne, J., Vantomme, B., Van Caenegem, E., Wierckx, K., De Blok, C. J. M., Klaver, M., Nota, N. M., Van Dijk, D., Wiepjes, C. M., Den Heijer, M., et al. (2018) · Andrology · doi:10.1111/andr.12485 · Cited by 114 · see citing works
Interpreting Laboratory Results in Transgender Patients on Hormone Therapy
Roberts, T. K., Kraft, C. S., French, D., Ji, W., Wu, A. H. B., Tangpricha, V., & Fantz, C. R. (2014) · The American Journal of Medicine · doi:10.1016/j.amjmed.2013.10.009 · Cited by 109 · see citing works
When Gender Identity Doesn't Equal Sex Recorded at Birth: The Role of the Laboratory in Providing Effective Healthcare to the Transgender Community
Goldstein, Z. G., Corneil, T., & Greene, D. N. (2017) · Clinical Chemistry · doi:10.1373/clinchem.2016.258780 · Cited by 78 · see citing works
Biological variation of hematology tests based on the 1999-2002 National Health and Nutrition Examination Survey.
Lacher, D. A., Barletta, J. M., & Hughes, J. P. (2012) · PubMed · Cited by 43 · see citing works
Common Hormone Therapies Used to Care for Transgender Patients Influence Laboratory Results
Humble, R. M., Imborek, K. L., Nisly, N. L., Greene, D. N., & Krasowski, M. D. (2018) · The Journal of Applied Laboratory Medicine · doi:10.1373/jalm.2018.027078 · Cited by 40 · see citing works
Changes in Hemoglobin Concentration and Hematocrit During the Menstrual Cycle
Vellar, O. D. (1974) · Acta Obstetricia Et Gynecologica Scandinavica · doi:10.3109/00016347409162164 · Cited by 38 · see citing works
Preferred Names, Preferred Pronouns, and Gender Identity in the Electronic Medical Record and Laboratory Information System: Is Pathology Ready?
Imborek, K. L., Nisly, N. L., Hesseltine, M. J., Grienke, J., Zikmund, T. A., Dreyer, N. R., Blau, J., Hightower, M., Humble, R. M., & Krasowski, M. D. (2017) · Journal of Pathology Informatics · doi:10.4103/jpi.jpi_52_17 · Cited by 38 · see citing works
Biological Variations of Hematologic Parameters Determined by UniCel DxH 800 Hematology Analyzer
Zhang, P., Tang, H., Chen, K., Chen, Y., & Xu, D. (2013) · Archives of Pathology & Laboratory Medicine · doi:10.5858/arpa.2012-0377-oa · Cited by 31 · see citing works
Could Testosterone Replacement Therapy in Hypogonadal Men Ameliorate Anemia, a Cardiovascular Risk Factor? An Observational, 54-Week Cumulative Registry Study
Zhang, L. T., Shin, Y. S., Kim, J. Y., & Park, J. K. (2015) · The Journal of Urology · doi:10.1016/j.juro.2015.10.130 · Cited by 28 · see citing works
How are hemoglobin levels affected by androgen deprivation in non-metastatic prostate cancer patients?
Choo, R. C., Chander, S., Danjoux, C. E., Morton, G., Pearce, A. G., DeBoer, G., Szumacher, E., Loblaw, A., Cheung, P., & Woo, T. C. S. (2005) · PubMed · Cited by 26 · see citing works
A Comparison of the Effect of Oral Contraceptives, Pregnancy and Sex on Iron Metabolism
Mardell, M., SYMMONS, C., & Zilva, J. F. (1969) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem-29-11-1489 · Cited by 25 · see citing works
Androgens correlate with increased erythropoiesis in women with congenital adrenal hyperplasia
Karunasena, N., Han, T. S., Mallappa, A., Elman, M., Merke, D. P., Ross, R. J. M., & Daniel, E. (2017) · Clinical Endocrinology · doi:10.1111/cen.13148 · Cited by 23 · see citing works
Comparison of haematological indices between women of four ethnic groups and the effect of oral contraceptives.
Godsland, I. F., Seed, M., Simpson, R., Broom, G., & Wynn, V. (1983) · Journal of Clinical Pathology · doi:10.1136/jcp.36.2.184 · Cited by 20 · see citing works
HAEMATOLOGICAL CHARACTERISTICS AND MENSTRUAL BLOOD LOSSES
COLE, S. K., Thomson, A. M. W., Billewicz, W. Z., & BLACK, A. E. (1972) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/j.1471-0528.1972.tb11877.x · Cited by 18 · see citing works

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1 of the 24 references couldn’t be matched to a known paper.

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Haematological actions of androgens
Warren, A. M., & Grossmann, M. (2022) · Best Practice & Research Clinical Endocrinology & Metabolism · doi:10.1016/j.beem.2022.101653 · Cited by 53 · see citing works
Dynamic Impact of Hormone Therapy on Laboratory Values in Transgender Patients over Time
Allen, A. N., Jiao, R., Day, P. G., Pagels, P., Gimpel, N. E., & SoRelle, J. A. (2020) · The Journal of Applied Laboratory Medicine · doi:10.1093/jalm/jfaa192 · Cited by 45 · see citing works
Longitudinal Changes in Hematologic Parameters Among Transgender People Receiving Hormone Therapy
Antun, A. G., Zhang, Q., Bhasin, S., Bradlyn, A. S., Flanders, W. D., Getahun, D. T., Lash, T. L., Nash, R., Roblin, D. W., Silverberg, M. J., et al. (2020) · Journal of the Endocrine Society · doi:10.1210/jendso/bvaa119 · Cited by 39 · see citing works
Reproductive Endocrinology Reference Intervals for Transgender Women on Stable Hormone Therapy
Greene, D. N., Schmidt, R. L., Winston‐McPherson, G. N., Rongitsch, J., Imborek, K. L., Dickerson, J. A., Drees, J. C., Humble, R. M., Nisly, N. L., Dole, N. J., et al. (2020) · The Journal of Applied Laboratory Medicine · doi:10.1093/jalm/jfaa028 · Cited by 36 · see citing works
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Alpert, A. B., Scout, N., Schabath, M. B., Adams, S., Obedin‐Maliver, J., & Safer, J. D. (2022) · American Society of Clinical Oncology Educational Book · doi:10.1200/edbk_350175 · Cited by 31 · see citing works
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Prince, J. C. J., & Safer, J. D. (2020) · Expert Review of Endocrinology & Metabolism · doi:10.1080/17446651.2020.1825075 · Cited by 22 · see citing works
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Authors: Greene, D. N., McPherson, G. W., Rongitsch, J., Imborek, K. L., Schmidt, R. L., Humble, R. M., Nisly, N., Dole, N. J., Dane, S. K., Frerichs, J., & Krasowski, M. D.
Affiliations: University of Washington (US)
University of Iowa Hospitals and Clinics (US)
University of Utah (US)
Corresponding author: Greene, Dina N.
ORCID: Greene, Dina N.
Imborek, Katherine L.
Schmidt, Robert L.
Humble, Robert M.
Nisly, Nicole
Krasowski, Matthew D.
Venue: Clinica Chimica Acta
Publisher: Elsevier BV
Published: 2019-05
Volume: 492
Pages: 84-90
ISSN: 0009-8981 (ISSN-L)
DOI: 10.1016/j.cca.2019.02.011
OpenAlex: W2914875623
Cited by: 61
References: 24
Citations by year: 2026: 3 · 2025: 4 · 2024: 13 · 2023: 7 · 2022: 16 · 2021: 7 · 2020: 11
FWCI: 5.81
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Clinica Chimica Acta (publishedVersion)
PubMed (publishedVersion)
Funders: University of Washington
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 adults, hormone therapy, complete blood count, testosterone, estrogen, hemoglobin, hematocrit, mean corpuscular volume, red cell distribution width, estradiol, total testosterone
MeSH terms: Adult, Estrogens, Female, Hematology, Hemoglobins, Hormones, Humans, Male, Middle Aged, Surveys and Questionnaires, Reference Values, Gonadal Steroid Hormones, Young Adult, Transgender Persons

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Hematology reference intervals for transgender adults on stable hormone therapy

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