Korpaisarn Sira, Chiewchalermsri Dararat, Arunakul Jiraporn, Chinthakanan Orawee, Poomthavorn Preamrudee, Sriphrapradang Chutintorn
Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
SAGE Open Med. 2021 Oct 10;9:20503121211051546. doi: 10.1177/20503121211051546. eCollection 2021.
Data regarding gender-affirming hormone therapy in the Asian population are sparse. We aimed to evaluate the efficacy and safety of testosterone therapy in transgender men.
A retrospective study chart review was conducted in a single university-based transgender clinic. Transgender men aged >18 years who newly started testosterone therapy during January 2015 to October 2019 were recruited. Physical changes, laboratory results, and adverse events, including cancer, thromboembolism, cardiovascular events, and death after masculinizing hormone therapy, were evaluated.
A total of 39 transgender men (mean age: 27.8 ± 6.0 years) were included. All individuals were treated with intramuscular testosterone injection with a mean follow-up of 25.2 ± 12.9 months. The most common maintenance regimen was testosterone enanthate 250 mg every 4 weeks. Masculinizing effects developed in all transgender men. There were no changes in body weight, and systolic and diastolic blood pressure. Hematocrit levels were 12% significantly increased from 39.9 ± 3.3% to 48.9 ± 2% (p < 0.001). Ten individuals (25.6%) had hematocrit >50%. Significant changes were found in decreased fasting plasma glucose, increased creatinine, and increased uric acid levels. A non-significantly increased alanine aminotransferase, increased low-density lipoprotein cholesterol, and decreased high-density lipoprotein cholesterol were observed. No thromboembolism, cancer, stroke, or coronary artery disease occurred.
Gender-affirming hormone therapy is an effective and safe short-term treatment in Thai transgender men. Apart from the standard recommendation, uric acid, plasma glucose, and creatinine level evaluation before and during masculinizing hormone therapy are rational practices. An intramuscular testosterone enanthate 250 mg every 4 weeks is an alternative masculinizing regimen with decent efficacy and safety profile.
关于亚洲人群性别确认激素治疗的数据很少。我们旨在评估睾酮治疗对 transgender 男性的疗效和安全性。
在一家大学附属的单一 transgender 诊所进行了一项回顾性研究图表审查。招募了 2015 年 1 月至 2019 年 10 月期间新开始睾酮治疗的年龄大于 18 岁的 transgender 男性。评估了身体变化、实验室检查结果以及不良事件，包括男性化激素治疗后的癌症、血栓栓塞、心血管事件和死亡情况。
共纳入 39 名 transgender 男性（平均年龄：27.8 ± 6.0 岁）。所有个体均接受肌肉注射睾酮治疗，平均随访 25.2 ± 12.9 个月。最常见的维持方案是每 4 周注射 250 mg 庚酸睾酮。所有 transgender 男性均出现男性化效应。体重、收缩压和舒张压无变化。血细胞比容水平从 39.9 ± 3.3%显著升高至 48.9 ± 2%（p < 0.001）。10 名个体（25.6%）的血细胞比容>50%。空腹血糖降低、肌酐升高和尿酸水平升高有显著变化。观察到丙氨酸转氨酶非显著升高、低密度脂蛋白胆固醇升高和高密度脂蛋白胆固醇降低。未发生血栓栓塞、癌症、中风或冠状动脉疾病。
性别确认激素治疗对泰国 transgender 男性是一种有效且安全的短期治疗方法。除了标准建议外，在男性化激素治疗前和治疗期间评估尿酸、血糖和肌酐水平是合理的做法。每 4 周肌肉注射 250 mg 庚酸睾酮是一种具有良好疗效和安全性的替代男性化方案。
