Department of Pediatric Hematology/Oncology, Walter Reed National Military Medical Center.
Departments of Pediatrics.
J Pediatr Hematol Oncol. 2022 Jul 1;44(5):e892-e895. doi: 10.1097/MPH.0000000000002442. Epub 2022 Mar 16.
Medical affirmation, including gender-affirming hormones, is an essential component in the treatment of many transgender and gender-diverse youth. The risk of venous thromboembolism (VTE) during testosterone therapy for gender-affirming care is not fully elucidated.
The case describes a 17-year-old transgender male treated with testosterone therapy who presented with an occlusive deep vein thrombosis of right axillary and subclavian veins. Testosterone level was 920 ng/dL at the time of the deep vein thrombosis, and he had no risk factors for VTE. A complete hypercoagulable workup was negative.
The possibility of testosterone therapy as a risk factor for VTE may suggest the need to include this information during informed consent discussions. Long-term anticoagulation may be considered for those restarting testosterone therapy.
医学确认，包括性别肯定激素，是许多跨性别和性别多样化青年治疗的重要组成部分。在性别肯定护理中使用睾丸激素治疗的静脉血栓栓塞（VTE）风险尚未完全阐明。
该病例描述了一名 17 岁的跨性别男性接受睾丸激素治疗，他出现了右侧腋静脉和锁骨下静脉的闭塞性深静脉血栓形成。深静脉血栓形成时，睾丸激素水平为 920ng/dL，他没有 VTE 的风险因素。全面的高凝状态检查结果为阴性。
睾丸激素治疗作为 VTE 风险因素的可能性可能表明在知情同意讨论中需要包括此信息。对于那些重新开始睾丸激素治疗的人，可能需要考虑长期抗凝治疗。
