Cross-Sex Hormones and Metabolic Parameters in Adolescents With Gender Dysphoria
Abstract
BACKGROUND AND OBJECTIVES: The Endocrine Society states that adolescents with gender dysphoria may start cross-sex hormones. The goal of this study was to identify patterns in metabolic parameters in transgender adolescents receiving cross-sex hormones. METHODS: Data from adolescents aged 14 to 25 years seen in 1 of 4 clinical sites between 2008 and 2014 were retrospectively analyzed. Subjects were divided into affirmed male (female-to-male) patients taking testosterone and affirmed female (male-to-female) patients taking estrogen. Previously recorded measurements of blood pressure, BMI, testosterone, estradiol, prolactin, lipids, electrolytes, liver function tests, hemoglobin/hematocrit, and hemoglobin A1c were reviewed. These values were obtained from before the start of therapy, at 1 to 3 months after initiation, at 4 to 6 months, and at 6 months and beyond. Repeated measures analysis of variance models were used to evaluate changes over time. RESULTS: One hunderd and sixteen adolescents were included (72 female-to-male subjects and 44 male-to-female subjects). Of the 72 subjects taking testosterone, a significant increase in hemoglobin/hematocrit levels and BMI, as well as a decrease in high-density lipoprotein level, was recorded at each visit. No significant changes in any other parameter tested were found. Of the 44 subjects taking estrogen, no statistically significant changes were noted in the measured metabolic parameters. CONCLUSIONS: Testosterone use was associated with increased hemoglobin and hematocrit, increased BMI, and lowered high-density lipoprotein levels; estrogen was associated with lower testosterone and alanine aminotransferase levels. Otherwise, cross-sex hormone administration in adolescents was not associated with significant differences in the selected metabolic parameters over time.
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Although the transwomen in most of the studies achieved testosterone levels within the reference range for cisgender women, there were five studies in which the transfemales had post-GAHT testosterone values greater than 5 nmol/L.
“Although the transwomen in most of the studies achieved testosterone levels within the reference range for cisgender women, there were five studies38 40 47 49 51 in which the transfemales had post-GAHT testosterone values greater than 5 nmol/L.”
In the study finding no significant difference, participants failed to reach typical female testosterone levels after 6 months (mean testosterone=6.9 nmol/L).
“The participants also failed to reach typical female testosterone levels (after 6 months mean testosterone=6.9 nmol/L)”
In the study finding no significant difference, participants had a mean age of 18 years and a range of 14-25 years.
“The mean age of participants in the latter study was 18 years and the range was 14–25 years.”
One study found no significant difference in Hgb/HCT after 6 months of hormone therapy.
“one study found no significant difference after 6 months.47”
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- Authors
- Jarin, J., Pine-Twaddell, E., Trotman, G., Stevens, J., Conard, L. A., Tefera, E., & Gomez-Lobo, V.
- Affiliations
- The University of Texas Southwestern Medical Center (US)
- University of Maryland, Baltimore (US)
- Cincinnati Children's Hospital Medical Center (US)
- MedStar Health Research Institute (US)
- Corresponding author
- Jarin, Jason
- Venue
- Pediatrics
- Publisher
- American Academy of Pediatrics (AAP)
- Published
- 2017-04-06
- Volume
- 139
- Issue
- 5
- Pages
- e20163173
- ISSN
- 0031-4005 (ISSN-L)
- 1098-4275
- OpenAlex
- W2604605537
- Cited by
- 119
- References
- 19
- Citations by year
- 2026: 2 · 2025: 10 · 2024: 12 · 2023: 10 · 2022: 15 · 2021: 25 · 2020: 16 · 2019: 15 · 2018: 12 · 2017: 2
- FWCI
- 17.61
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- PEDIATRICS (publishedVersion)
- PubMed (publishedVersion)
- 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 dysphoria, transgender youth, cross-sex hormones, testosterone, estrogen, metabolic parameters, hemoglobin, hematocrit, body mass index, high-density lipoprotein, alanine aminotransferase, liver function tests, prolactin, blood pressure, electrolytes
- MeSH terms
- Gender Dysphoria, Adolescent, Adult, Alanine Transaminase, Female, Hematocrit, Glycated Hemoglobin, Humans, Cholesterol, HDL, Male, Retrospective Studies, Gonadal Steroid Hormones, Testosterone, Body Mass Index, Young Adult
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