Cross-sex hormone therapy in trans persons is safe and effective at short-time follow-up: results from the European network for the investigation of gender incongruence
Open accessAbstract
INTRODUCTION: Data on the effects of cross-sex hormone therapy (CHT) are limited due to the low prevalence of gender dysphoria, small number of subjects treated at each center, lack of prospective studies, and wide variations in treatment modalities. AIM: The aim of this study is to report the short-term effects of CHT on hormonal and clinical changes, side effects, and adverse events in trans men (female-to-male gender dysphoric persons) and trans women (male-to-female gender dysphoric persons). METHODS: This was a multicenter 1-year prospective study in 53 trans men and 53 trans women. Trans men received injections of testosterone undecanoate every 3 months. Trans women younger than 45 years received 50 mg cyproterone acetate (CA) and 4 mg estradiol valerate daily, whereas those older than 45 years received 50 mg CA daily together with 100 μg/24 hours transdermal 17-β estradiol. MAIN OUTCOME MEASURES: Sex steroids, prolactin, liver enzymes, lipids, hematocrit, blood pressure, anthropometrics, Ferriman and Gallwey score, and global acne grading scale were measured. Side effects, adverse events, and desired clinical changes were examined. RESULTS: No deaths or severe adverse events were observed. Two trans men developed erythrocytosis, and two had transient elevation of the liver enzymes. Trans men reported an increase in sexual desire, voice instability, and clitoral pain (all P ≤ 0.01). Testosterone therapy increased acne scores, facial and body hair, and prevalence of androgenetic alopecia. Waist-hip ratio, muscle mass, triglycerides, total cholesterol (C), and LDL-C increased, whereas total body fat mass and HDL-C decreased. Three trans women experienced transient elevation of liver enzymes. A significant increase in breast tenderness, hot flashes, emotionality, and low sex drive was observed (all P ≤ 0.02). Fasting insulin, total body fat mass, and prolactin levels increased, and waist-hip ratio, lean mass, total C, and LDL-C decreased. CONCLUSIONS: Current treatment modalities were effective and carried a low risk for side effects and adverse events at short-time follow-up.
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Seven of the follow-up studies, including the large ENIGI study, and two studies with high post-GAHT testosterone, showed that total lean body mass was decreased by 3.0%-5.4% following hormone transition (p<0.05).
“Seven of these studies,15 36 39–41 44 51 including the large (n=179) ENIGI study,15 and two studies40 51 with high post-GAHT testosterone (~8 nmol/L), showed that total LBM was decreased by 3.0%–5.4% following hormone transition (p<0.05).”
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 [36]
The Trans Women results report a decrease in total body lean mass after treatment, and Table 3 (page not available) shows significant decreases in both estrogen-treatment groups at 12 months (P<0.001 and P=0.02). But Table 3 lists 53 trans women and 53 trans men, not a follow-up sample of 179; this paper also cannot substantiate the results attributed to the other six studies or the two studies described as having high post-GAHT testosterone. (LLM, conf=0.86)
Experimental — accuracy not yet measuredIn six of the eight other studies, mean testosterone after GAHT was less than 2.0 nmol/L.
“while in six16 19 36 37 43 48 of the eight other studies mean testosterone after GAHT was less than 2.0 nmol/L.”
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 [36]
Table 2 reports 12-month testosterone values of 10.7 and 14.0 ng/dL for trans women receiving oral and transdermal estrogens, respectively—both well below 2.0 nmol/L. The Statistical Analysis section indicates that values presented with quartile ranges are medians, not means. This paper supports a low post-treatment testosterone value for this study, but does not establish the claimed mean or the count across eight studies. (LLM, conf=0.84)
Experimental — accuracy not yet measuredEight of the nine studies found that hormone therapy led to a significant decrease in Hgb/HCT of 4.6%-14.0% (p<0.01).
“Eight of these studies,16 19 36–38 43 48 49 including the large (n=239) ENIGI study,19 found that hormone therapy led to a significant (4.6%–14.0%) decrease in Hgb/HCT (p<0.01)”
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 [36]
The hematocrit results table (indexed under Conclusion; page unavailable) shows significant decreases in both trans-women treatment groups, with p=0.003 and p<0.001. But the Abstract reports 53 trans women and 53 trans men, not an ENIGI study of 239 participants. This paper also does not establish the citing sentence’s count of eight of nine studies or its overall 4.6%–14.0% range. (LLM, conf=0.88)
Experimental — accuracy not yet measuredNine studies reported Hgb or HCT levels in transwomen before and after GAHT, with follow-up from a minimum of 3 to a maximum of 36 months post hormone therapy.
“Nine studies16 19 36–38 43 47–49 reported the levels of Hgb or HCT in transwomen before and after GAHT, from a minimum of three to a maximum of 36 months post hormone therapy.”
Twelve longitudinal studies have examined the effects of testosterone suppression on lean body mass or muscle size in transgender women.
“Including Gooren and Bunck [62], 12 longitudinal studies [53, 63–73] have examined the effects of testosterone suppression on lean body mass or muscle size in transgender women.”
From Transgender Women in the Female Category of Sport: Perspectives on Testosterone Suppression and Performance Advantage (2021) · cites this paper as [65]
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Cites
Clinical assessment of body hair growth in women.
Ferriman, D., & Gallwey, J. D. (1961) · Journal of Clinical Endocrinology and Metabolism · doi:10.1210/jcem-21-11-1440 · Cited by 2,556 · see citing works
The role of estrogens in control of energy balance and glucose homeostasis
Mauvais-Jarvis, F., Clegg, D. J., & Hevener, A. L. (2013) · Endocrine Reviews · doi:10.1210/er.2012-1055 · Cited by 1,329 · see citing works
Endocrine Treatment of Transsexual Persons:An Endocrine Society Clinical Practice Guideline
Hembree, W. C., Cohen‐Kettenis, P. T., de Waal, H. A. D., Gooren, L. J., Meyer, W. J., Spack, N. P., Tangpricha, V., & Montori, V. M. (2009) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2009-0345 · Cited by 1,029 · see citing works
Male Pattern Baldness: classification and Incidence
Norwood, O. T. (1975) · Southern Medical Journal · doi:10.1097/00007611-197511000-00009 · Cited by 893 · see citing works
Dhejne, C., Lichtenstein, P., Boman, M., Johansson, A. L. V., Långström, N., & Landén, M. (2011) · PLoS ONE · doi:10.1371/journal.pone.0016885 · Cited by 619 · see citing works
A long-term follow-up study of mortality in transsexuals receiving treatment with cross-sex hormones
Asscheman, H., Giltay, E. J., Megens, J. A. J., de Ronde, W., van Trotsenburg, M. A. A., & Gooren, L. J. (2011) · European Journal of Endocrinology · doi:10.1530/eje-10-1038 · Cited by 570 · see citing works
Mortality and morbidity in transsexual subjects treated with cross‐sex hormones
van Kesteren, P. J. M., Asscheman, H., Megens, J. A. J., & Gooren, L. J. (1997) · Clinical Endocrinology · doi:10.1046/j.1365-2265.1997.2601068.x · Cited by 532 · see citing works
Sex Differences in Lipid and Lipoprotein Metabolism: It's Not Just about Sex Hormones
Wang, X., Magkos, F., & Mittendorfer, B. (2011) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2010-2061 · Cited by 424 · see citing works
Induction of insulin resistance by androgens and estrogens
Polderman, K. H., Gooren, L. J., Asscheman, H., Bakker, A., & Heine, R. J. (1994) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.79.1.8027240 · Cited by 382 · see citing works
Sexual and Physical Health After Sex Reassignment Surgery
Cuypere, G. D., T'Sjoen, G. G., Beerten, R., Selvaggi, G., Sutter, P. D., Hoebeke, P. B., Monstrey, S., Vansteenwegen, A., & Rubens, R. (2005) · Archives of Sexual Behavior · doi:10.1007/s10508-005-7926-5 · Cited by 367 · see citing works
Self-citationLong-Term Evaluation of Cross-Sex Hormone Treatment in Transsexual Persons
Wierckx, K., Mueller, S. C., Weyers, S., Caenegem, E. V., Roef, G. L., Heylens, G., & T'Sjoen, G. G. (2012) · The Journal of Sexual Medicine · doi:10.1111/j.1743-6109.2012.02876.x · Cited by 338 · see citing works
Self-citationWierckx, K., Elaut, E., Declercq, E., Heylens, G., Cuypere, G. D., Taes, Y., Kaufman, J., & T'Sjoen, G. G. (2013) · European Journal of Endocrinology · doi:10.1530/eje-13-0493 · Cited by 327 · see citing works
Self-citationEffects of sex steroids on components of the insulin resistance syndrome in transsexual subjects
Elbers, J. M. H., Giltay, E. J., Teerlink, T., Scheffer, P. G., Asscheman, H., Seidell, J. C., & Gooren, L. J. (2003) · Clinical Endocrinology · doi:10.1046/j.1365-2265.2003.01753.x · Cited by 318 · see citing works
Comparison of pharmacodynamic properties of various estrogen formulations
Mashchak, C. A., Lobo, R. A., Dozono-Takano, R., Eggena, P., Nakamura, R. M., Brenner, P. F., & Mishell, D. R. (1982) · American Journal of Obstetrics and Gynecology · doi:10.1016/0002-9378(82)90218-6 · Cited by 316 · see citing works
Long-Term Treatment of Transsexuals with Cross-Sex Hormones: Extensive Personal Experience
Gooren, L. J., Giltay, E. J., & Bunck, M. C. (2008) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2007-1809 · Cited by 308 · see citing works
Moore, E. M., Wisniewski, A. B., & Dobs, A. S. (2003) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2002-021967 · Cited by 288 · see citing works
Gooren, L. J. (2011) · New England Journal of Medicine · doi:10.1056/nejmcp1008161 · Cited by 228 · see citing works
Mortality and morbidity in transsexual patients with cross-gender hormone treatment
Asscheman, H., Gooren, L. J., & Eklund, P. L. E. (1989) · Metabolism · doi:10.1016/0026-0495(89)90233-3 · Cited by 220 · see citing works
Yialamas, M. A., Dwyer, A. A., Hanley, E., Lee, H., Pitteloud, N., & Hayes, F. J. (2007) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2007-0454 · Cited by 220 · see citing works
Dréno, B., Khammari, A., Orain, N., Noray, C., Merial‐Kieny, C., Méry, S., & Nocera, T. (2006) · Dermatology · doi:10.1159/000096912 · Cited by 217 · see citing works
Hormone-treated transsexuals report less social distress, anxiety and depression
Gómez‐Gil, E., Zubiaurre‐Elorza, L., Esteva, I., Guillamón, A., Godás, T., Almaraz, M. C., Halperín, I., & Salamero, M. (2011) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2011.08.010 · Cited by 209 · see citing works
Toorians, A. W. F. T., Thomassen, S., Zweegman, S., Magdeleyns, E. J. P., Tans, G., Gooren, L. J., & Rosing, J. (2003) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2003-030520 · Cited by 207 · see citing works
Central and peripheral regulation of prolactin function
MacLeod, R. M., & Scapagnini, U. (1980) · Raven Press eBooks · Cited by 172 · see citing works
A European network for the investigation of gender incongruence: The ENIGI initiative
Kreukels, B. P. C., Haraldsen, I., Cuypere, G. D., Richter‐Appelt, H., Gijs, L. A. C. L., & Cohen‐Kettenis, P. T. (2010) · European Psychiatry · doi:10.1016/j.eurpsy.2010.04.009 · Cited by 146 · see citing works
Self-citationEndocrine Treatment of Male-to-Female Transsexuals Using Gonadotropin-Releasing Hormone Agonist
Dittrich, R., Binder, H., Cupisti, S., Hoffmann, I., Beckmann, M., & Mueller, A. (2005) · Experimental and Clinical Endocrinology & Diabetes · doi:10.1055/s-2005-865900 · Cited by 141 · see citing works
Caenegem, E. V., Wierckx, K., Taes, Y., Dedecker, D., de Peer, F. V., Toye, K. R. C., Kaufman, J., & T'Sjoen, G. G. (2012) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2012-1187 · Cited by 139 · see citing works
Self-citationMueller, A., Kiesewetter, F., Binder, H., Beckmann, M. W., & Dittrich, R. (2007) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2007-0746 · Cited by 131 · see citing works
Ågren, U. M., Anttila, M., Mäenpää-Liukko, K., Rantala, M.-L., Rautiainen, H., Sommer, W. F., & Mommers, E. (2011) · The European Journal of Contraception & Reproductive Health Care · doi:10.3109/13625187.2011.604450 · Cited by 130 · see citing works
Fiers, T., Casetta, B., Bernaert, B., Vandersypt, E., Debock, M., & Kaufman, J. (2012) · Journal of Chromatography B · doi:10.1016/j.jchromb.2012.02.034 · Cited by 127 · see citing works
Self-citationScott, R. T., Ross, B., Anderson, C., et al. (1991) · PubMed · Cited by 112 · see citing works
Prior, J. C., Vigna, Y. M., & Watson, D. B. (1989) · Archives of Sexual Behavior · doi:10.1007/bf01579291 · Cited by 109 · see citing works
Seal, L., Franklin, S. L., Richards, C., Shishkareva, A., Sinclaire, C., & Barrett, J. (2012) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2012-2030 · Cited by 104 · see citing works
PROLACTIN LEVELS AND PITUITARY ENLARGEMENT IN HORMONE-TREATED MALE-TO-FEMALE TRANSSEXUALS
Asscheman, H., Gooren, L. J., Assies, J., SMITS, J. P. H., & Slegte, R. G. M. D. (1988) · Clinical Endocrinology · doi:10.1111/j.1365-2265.1988.tb03849.x · Cited by 95 · see citing works
Giltay, E. J., Elbers, J. M. H., Gooren, L. J., et al. (1998) · Arteriosclerosis Thrombosis and Vascular Biology · doi:10.1161/01.atv.18.11.1716 · Cited by 88 · see citing works
Schlatterer, K., Yassouridis, A., von Werder, K., Poland, D., Kemper, J., & Stalla, G. K. (1998) · Archives of Sexual Behavior · doi:10.1023/a:1018704630036 · Cited by 64 · see citing works
Endocrinologic Treatment of Gender Identity Disorders
Tangpricha, V., Ducharme, S. H., Barber, T. W., & Chipkin, S. R. (2003) · Endocrine Practice · doi:10.4158/ep.9.1.12 · Cited by 60 · see citing works
Scott, R. T., Ross, B., Anderson, C., et al. (1991) · Maturitas · doi:10.1016/0378-5122(91)90184-r · Cited by 53 · see citing works
Gooren, L. J., Harmsen‐Louman, W., & van Kessel, H. (1985) · Clinical Endocrinology · doi:10.1111/j.1365-2265.1985.tb01081.x · Cited by 46 · see citing works
Giltay, E. J., Gooren, L. J., EMEIS, J. J., Kooistra, T., & Stehouwer, C. D. A. (2000) · Arteriosclerosis Thrombosis and Vascular Biology · doi:10.1161/01.atv.20.5.1396 · Cited by 46 · see citing works
Sex Steroids, Insulin, and Arterial Stiffness in Women and Men
Giltay, E. J., Lambert, J., Gooren, L. J., Elbers, J. M. H., Steyn, M., & Stehouwer, C. D. A. (1999) · Hypertension · doi:10.1161/01.hyp.34.4.590 · Cited by 46 · see citing works
Giltay, E. J., Gooren, L. J., EMEIS, J. J., Kooistra, T., & Stehouwer, C. D. A. (2000) · Thrombosis and Haemostasis · doi:10.1055/s-0037-1614026 · Cited by 33 · see citing works
Mueller, A., Binder, H., Cupisti, S., et al. (2006) · Hormone and Metabolic Research · doi:10.1055/s-2006-925198 · Cited by 26 · see citing works
Flagged first, then by citations
Research works printed but not linked: 2
- Schlatterer K, Yassouridis A, von Werder K, Poland D, Kemper J, Stalla G. A follow-up study for estimating the effec- tiveness of a cross-gender hormone substitution therapy on transsexual patients. Arch Sex Behav 1998;27:475-92.
- Wierckx K, Elaut E, Declerq E, Heylens G, Decuypere G, Taes Y, Kaufman JM, T'sjoen GR. Prevalence of cardiovascu- lar disease and cancer during CHT in a large cohort of trans persons: A case control study. Eur J Endocrinol 2013;169: 471-8.
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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
Self-citationTestosterone 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
Klaver, M., de Blok, C. J. M., Wiepjes, C. M., Nota, N. M., Dekker, M. J. H. J., de Mutsert, R., Schreiner, T., Fisher, A. D., T’Sjoen, G., & den Heijer, M. (2018) · European Journal of Endocrinology · doi:10.1530/eje-17-0496 · Cited by 198 · see citing works
Self-citationAdult development and quality of life of transgender and gender nonconforming people
Bockting, W., Coleman, E., Deutsch, M. B., Guillamon, A., Meyer, I., Meyer, W., Reisner, S., Sevelius, J., & Ettner, R. (2016) · Current Opinion in Endocrinology, Diabetes & Obesity · doi:10.1097/med.0000000000000232 · Cited by 181 · see citing works
Hilton, E. N., & Lundberg, T. R. (2021) · Sports Medicine · doi:10.1007/s40279-020-01389-3 · Cited by 170 · see citing works
Harper, J., O'Donnell, E., Sorouri Khorashad, B., McDermott, H., & Witcomb, G. L. (2021) · British Journal of Sports Medicine · doi:10.1136/bjsports-2020-103106 · Cited by 167 · see citing works
Velho, I., Fighera, T. M., Ziegelmann, P. K., & Spritzer, P. M. (2017) · Andrology · doi:10.1111/andr.12382 · Cited by 160 · see citing works
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
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SoRelle, J. A., Jiao, R., Gao, E., Veazey, J., Frame, I., Quinn, A. M., Day, P., Pagels, P., Gimpel, N., & Patel, K. (2019) · Clinical Chemistry · doi:10.1373/clinchem.2018.292730 · Cited by 86 · see citing works
Auer, M. K., Ebert, T., Pietzner, M., Defreyne, J., Fuss, J., Stalla, G. K., & T’Sjoen, G. (2018) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2017-01559 · Cited by 75 · see citing works
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Scharff, M., Wiepjes, C. M., Klaver, M., Schreiner, T., T’Sjoen, G., & den Heijer, M. (2019) · Endocrine Connections · doi:10.1530/ec-19-0196 · Cited by 64 · see citing works
Self-citationTack, L. J. W., Craen, M., Lapauw, B., Goemaere, S., Toye, K., Kaufman, J.-M., Vandewalle, S., T’Sjoen, G., Zmierczak, H.-G., & Cools, M. (2018) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2017-02316 · Cited by 63 · see citing works
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- Authors
- Wierckx, K., Van Caenegem, E., Schreiner, T., Haraldsen, I., Fisher, A., Toye, K., Kaufman, J. M., & T'Sjoen, G.
- Affiliations
- Ghent University Hospital (BE)
- Department of Endocrinology , Ghent , Belgium
- Oslo University Hospital (NO)
- University of Florence (IT)
- Corresponding author
- Wierckx, Katrien
- ORCID
- Venue
- The Journal of Sexual Medicine
- Publisher
- Oxford University Press (OUP)
- Published
- 2014-08-01
- Volume
- 11
- Issue
- 8
- Pages
- 1999-2011
- ISSN
- 1743-6095 (ISSN-L)
- 1743-6109
- OpenAlex
- W2160971157
- Cited by
- 316
- References
- 42
- Citations by year
- 2026: 14 · 2025: 19 · 2024: 40 · 2023: 32 · 2022: 38 · 2021: 41 · 2020: 42 · 2019: 29 · 2018: 17 · 2017: 19 · 2016: 18 · 2015: 5 · 2014: 2
- FWCI
- 21.73
- Type
- journal article
- Language
- en
- Update notices
- erratum (2016-04-01)
- Open access
- green
- hdl.handle.net
- Licence
- Locations
- The Journal of Sexual Medicine (publishedVersion)
- PubMed (publishedVersion)
- Florence Research (University of Florence) (submittedVersion, other-oa)
- Ghent University Academic Bibliography (Ghent University) (submittedVersion)
- Funders
- Fonds Wetenschappelijk Onderzoek
- Universiteit Gent
- Vlaamse regering
- Fonds Spéciaux de Recherche
- Topics
- Social Sciences › Psychology › Social Psychology › LGBTQ Health, Identity, and Policy
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Sexual Differentiation and Disorders
- Keywords
- gender-affirming hormone therapy, gender dysphoria, transgender men, transgender women, testosterone undecanoate, cyproterone acetate, estradiol valerate, transdermal estradiol, adverse events, erythrocytosis, acne, androgenetic alopecia, prolactin, lipid profile, body composition, sexual desire, treatment safety
- MeSH terms
- Adult, Androgen Antagonists, Androgens, Estradiol, Estrogens, Female, Follow-Up Studies, Humans, Insulin, Male, Prospective Studies, Gonadal Steroid Hormones, Testosterone, Transsexualism, Cyproterone Acetate, Waist-Hip Ratio, Lipid Metabolism, Young Adult
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