Fung Raymond, Greenaway Mary Kathleen, McEvenue Giancarlo
Division of Endocrinology, Department of Medicine, Michael Garron Hospital, University of Toronto, Toronto, Canada.
University of Toronto, Toronto, Canada.
AACE Clin Case Rep. 2021 May 12;7(6):350-352. doi: 10.1016/j.aace.2021.05.003. eCollection 2021 Nov-Dec.
To describe the case of a 17-year-old transgender boy who experienced breast development while on testosterone, having been suppressed with a gonadotropin-releasing hormone (GnRH) agonist prior to testosterone therapy.
A 17-year-old transgender boy presented with breast development after having been on a GnRH agonist and then testosterone since the age of 11 years, having never experienced breast development before, which was consistent with pubertal gynecomastia. A small decrease in the testosterone dose resulted in a significant reduction of gynecomastia. Despite the improvement, he went on to undergo chest surgery with the removal of the breast tissue.
Pubertal gynecomastia is a common phenomenon in the cisgender male population. However, it has not been previously described in transgender boys. The potential mechanisms for its occurrence were discussed.
Transgender boys who undergo GnRH agonist treatment for puberty suppression and subsequently receive testosterone therapy for puberty induction may develop gynecomastia. Judicious adjustment of the testosterone therapy may lead to an improvement.
描述一名17岁变性男孩的病例，该男孩在接受睾酮治疗期间出现乳房发育，在开始睾酮治疗前曾使用促性腺激素释放激素（GnRH）激动剂抑制性腺功能。
一名17岁变性男孩自11岁起先后使用GnRH激动剂和睾酮，此前从未出现过乳房发育，此次出现乳房发育，符合青春期男性乳房增生。睾酮剂量小幅降低导致男性乳房增生明显减轻。尽管症状有所改善，但他仍接受了乳房组织切除的胸部手术。
青春期男性乳房增生在顺性别男性群体中是一种常见现象。然而，此前在变性男孩中尚未有过相关描述。文中讨论了其发生的潜在机制。
接受GnRH激动剂抑制青春期发育并随后接受睾酮诱导青春期发育的变性男孩可能会出现男性乳房增生。谨慎调整睾酮治疗可能会有所改善。
