The Pritzker School of Medicine, The University of Chicago Medical Center, Chicago, Illinois, USA.
Department of Surgery, Section of Urology, The University of Chicago Medical Center, Chicago, Illinois, USA.
Neurourol Urodyn. 2023 Jun;42(5):921-930. doi: 10.1002/nau.25094. Epub 2022 Nov 20.
Gender dysphoria is the discrepancy between biological sex and gender identity. This can be debilitating for transgender populations, including transgender men (TM), individuals who were assigned female at birth but who identify as men, that can benefit from hormonal therapy with testosterone products to address gender dysphoria.
We aim to summarize the efficacy, safety profile, and outcomes of the different testosterone replacement treatment (TRT) in the TM population. A search of the published literature regarding the various FDA-approved TRT was performed in PubMed, Web of Science and Cochrane Library from 2007 to date.
We complied two groups of TRT based on route of administration including the conventional testosterone therapies (intramuscular and subcutaneous injectables, and transdermal gels) and newer testosterone therapies (oral, buccal, and nasal gels). For the conventional testosterone therapies, we identified nine studies discussed conventional TRT in TM population including one randomized trial, four prospective studies, one retrospective study and three reviews. For newer testosterone therapies, we identified three studies discussed newer TRT in TM population including one prospective study and two reviews. Articles were then compiled and analyzed. Albeit majority of TRT data stemming from conventional TRT, there appear to be an overwhelmingly safety and efficacy profile in TM population translated with increased free testosterone levels comparable to male range, menses cessation, anxiety/depression decline and improved quality of life.
Testosterone therapy can be impactful for TM population with improved safety, efficiency, quality of life and function. With the rise of the newer FDA-approved TRT, randomized studies are warranted to determine its safety and efficacity in this TM population.
性别焦虑是指生物性别与性别认同之间的差异。这可能会使跨性别者感到痛苦，包括跨性别男性（TM），即那些出生时被指定为女性但认同为男性的人，可以通过接受睾丸酮产品的激素治疗来缓解性别焦虑。
我们旨在总结不同睾丸酮替代治疗（TRT）在 TM 人群中的疗效、安全性概况和结果。在 PubMed、Web of Science 和 Cochrane Library 中对 2007 年以来关于各种 FDA 批准的 TRT 的已发表文献进行了搜索。
我们根据给药途径将 TRT 分为两组，包括传统的睾丸酮治疗（肌肉内和皮下注射剂，以及透皮凝胶）和新的睾丸酮治疗（口服、颊部和鼻腔凝胶）。对于传统的睾丸酮治疗，我们确定了九项关于 TM 人群中传统 TRT 的研究，其中包括一项随机试验、四项前瞻性研究、一项回顾性研究和三项综述。对于新的睾丸酮治疗，我们确定了三项关于 TM 人群中新的 TRT 的研究，其中包括一项前瞻性研究和两项综述。然后对文章进行了汇编和分析。尽管大多数 TRT 数据来自于传统的 TRT，但在 TM 人群中似乎具有极高的安全性和疗效，表现为游离睾丸酮水平显著升高，与男性范围相当，停经、焦虑/抑郁程度下降，生活质量提高。
睾丸酮治疗对 TM 人群有显著影响，可以提高安全性、效率、生活质量和功能。随着新的 FDA 批准的 TRT 的出现，需要进行随机研究来确定其在 TM 人群中的安全性和疗效。
