Cross-Sex Hormones and Metabolic Parameters in Adolescents With Gender Dysphoria.

MedStar author(s):
Citation: Pediatrics. 139(5), 2017 MayPMID: 28557738Institution: MedStar Health Research Institute | MedStar Washington Hospital CenterDepartment: Obstetrics and Gynecology/Pediatric and AdolescentForm of publication: Journal ArticleMedline article type(s): Journal ArticleYear: 2017Local holdings: Available online from the MWHC library: 1948 - present, Available in print through MWHC library: 1999 - 2006MH - AdolescentMH - AdultMH - Alanine Transaminase/bl [Blood]MH - Body Mass IndexMH - Cholesterol, HDL/bl [Blood]MH - FemaleMH - *Gender Dysphoria/bl [Blood]MH - *Gender Dysphoria/dt [Drug Therapy]MH - Gonadal Steroid Hormones/ae [Adverse Effects]MH - *Gonadal Steroid Hormones/tu [Therapeutic Use]MH - HematocritMH - Hemoglobin A, Glycosylated/me [Metabolism]MH - HumansMH - MaleMH - Retrospective StudiesMH - Testosterone/bl [Blood]MH - Young AdultISSN:
  • 0031-4005
Name of journal: PediatricsAbstract: 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.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.Copyright (c) 2017 by the American Academy of Pediatrics.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.All authors: Conard LA, Gomez-Lobo V, Jarin J, Pine-Twaddell E, Stevens J, Tefera E, Trotman GFiscal year: FY2017Digital Object Identifier: Date added to catalog: 2017-06-14
Holdings
Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article 28557738 Available 28557738

Available online from the MWHC library: 1948 - present, Available in print through MWHC library: 1999 - 2006MH - AdolescentMH - AdultMH - Alanine Transaminase/bl [Blood]MH - Body Mass IndexMH - Cholesterol, HDL/bl [Blood]MH - FemaleMH - *Gender Dysphoria/bl [Blood]MH - *Gender Dysphoria/dt [Drug Therapy]MH - Gonadal Steroid Hormones/ae [Adverse Effects]MH - *Gonadal Steroid Hormones/tu [Therapeutic Use]MH - HematocritMH - Hemoglobin A, Glycosylated/me [Metabolism]MH - HumansMH - MaleMH - Retrospective StudiesMH - Testosterone/bl [Blood]MH - Young Adult

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.

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.

Copyright (c) 2017 by the American Academy of Pediatrics.

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.

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