Department of Obstetrics and Gynecology, Sapporo Medical University, Sapporo, Japan.
Department of Gynecology, Tonan Hospital, Sapporo, Japan.
J Obstet Gynaecol Res. 2022 Aug;48(8):2208-2213. doi: 10.1111/jog.15231. Epub 2022 Mar 18.
This study was performed to determine the proportion of transgender women with self-adjusted hormone administration and excess dosing.
The medical records of 87 transgender women who visited our gender clinic from 2010 through 2019 were reviewed. The complete blood count and serum concentrations of D-dimer, gonadotropins, and sex steroids were compared between transgender women who were self-administering gender-affirming hormones and women not using such hormones.
Fifty-eight of 87 (66.7%) transgender women had contravened the guideline and self-adjusted their hormone administration. The hormonal data of one woman with hypopituitarism were eliminated from the analyses. The serum gonadotropin and testosterone levels were significantly lower in the self-administration group than in the hormone-naïve group. Gonadotropin levels below the lower limit of normal were found in 32/86 (37.2%) transgender women. The testosterone levels in six transgender women were not analyzed because these women had undergone sex reassignment surgery before visiting our hospital. Testosterone levels below the lower limit of normal men were found in 36/80 (45.0%) transgender women. Unexpectedly, 29/36 (80.6%) transgender women who were classified as having suppressed serum testosterone levels had testosterone levels of <0.6 ng/mL, which corresponds to the levels in cisgender women. The white blood cell count and hemoglobin concentration were significantly different between the groups.
Self-initiated hormonal treatments seem to affect the serum concentrations of gonadotropin and sex steroids and the complete blood count. The prevalence of transgender women with self-adjusted use of gender-affirming hormones is high, and an excess dose of hormones occasionally occurs.
本研究旨在确定自行调整激素治疗且剂量过大的跨性别女性比例。
回顾了 2010 年至 2019 年期间在我院性别诊所就诊的 87 名跨性别女性的病历。比较了自行使用性别肯定激素和不使用此类激素的跨性别女性的全血细胞计数和血清 D-二聚体、促性腺激素和性激素浓度。
87 名跨性别女性中有 58 名（66.7%）违反了指南并自行调整了激素治疗。由于一名垂体功能减退症女性的激素数据被排除在分析之外。与激素未使用组相比，自行用药组的血清促性腺激素和睾酮水平明显降低。32/86（37.2%）名跨性别女性的促性腺激素水平低于正常值下限。由于 6 名跨性别女性在来我院就诊前已接受了性别重置手术，因此未对其进行睾酮分析。36/80（45.0%）名跨性别女性的睾酮水平低于男性正常值下限。出乎意料的是，29/36（80.6%）被归类为血清睾酮水平抑制的跨性别女性的睾酮水平<0.6ng/mL，这与顺性别女性的水平相当。两组间的白细胞计数和血红蛋白浓度存在显著差异。
自行发起的激素治疗似乎会影响促性腺激素和性激素以及全血细胞计数的血清浓度。自行调整使用性别肯定激素的跨性别女性的患病率较高，且激素剂量偶尔会过大。
