Boogers Lidewij S, Sardo Infirri Sebastiaan A, Bouchareb Asma, Dijkman Benthe A M, Helder Danithsia, de Blok Christel J M, Liberton Niels P T J, den Heijer Martin, van Trotsenburg A S Paul, Dreijerink Koen M A, Wiepjes Chantal M, Hannema Sabine E
Center of Expertise on Gender Dysphoria, Amsterdam UMC location VUmc, 1081 HZ Amsterdam, the Netherlands.
Amsterdam Gastroenterology Endocrinology Metabolism, 1081 HZ Amsterdam, the Netherlands.
J Clin Endocrinol Metab. 2025 Apr 22;110(5):e1404-e1410. doi: 10.1210/clinem/dgae573.
Breast development is an important outcome for trans women receiving gender-affirming hormone therapy (GAHT). Limited breast development has been reported, possibly because of testosterone exposure during puberty. The impact of puberty suppression (PS) on breast development is unclear.
To investigate the impact of PS and timing of PS prior to GAHT on breast volume and satisfaction.
In a cross-sectional study at a tertiary gender identity clinic, 60 trans women (aged 17-57 years) after 4.5 ± 1.7 years of GAHT were included, of whom 23 initiated PS early in puberty (Tanner stage G2-3), 17 late in puberty (Tanner stage G4-5), and 20 started GAHT in adulthood without prior PS. Breast volume was measured with a 3D scanner and breast satisfaction measured with a questionnaire. Comparisons of breast volumes were adjusted for fat percentage.
Median breast volume was 115 mL (IQR, 68; 203), ie, bra cup size < A. Breast volume was 47 mL (95% CI, -9; 104) larger in the late PS group compared to early PS but this difference was only 4 mL (95% CI, -67; 75) after correction for fat percentage. Breast volume in the adult group was comparable to the early and late PS groups (adult vs early PS 27 mL [95% CI, -28; 83] and adult vs late PS -20 mL [95% CI, -80; 40]). In total, 68% of subjects were satisfied with breast size (57% of early PS, 76% of late PS, and 70% of adult group).
Early start of PS was not associated with larger breast volume, suggesting that pubertal testosterone exposure does not affect breast volume after subsequent GAHT. Despite limited breast size, most trans women were satisfied with their breast development.
乳房发育是接受性别确认激素治疗（GAHT）的跨性别女性的一项重要结果。据报道乳房发育有限，这可能是由于青春期接触睾酮所致。青春期抑制（PS）对乳房发育的影响尚不清楚。
研究PS及GAHT前PS的时机对乳房体积和满意度的影响。
在一家三级性别认同诊所进行的一项横断面研究中，纳入了60名接受GAHT 4.5±1.7年的跨性别女性（年龄17 - 57岁），其中23人在青春期早期（坦纳分期G2 - 3）开始PS，17人在青春期晚期（坦纳分期G4 - 5）开始PS，20人在成年期开始GAHT且未进行过PS。用3D扫描仪测量乳房体积，用问卷测量乳房满意度。乳房体积比较针对脂肪百分比进行了调整。
乳房体积中位数为115毫升（四分位间距，68；203），即胸罩罩杯尺寸小于A。与早期PS组相比，晚期PS组的乳房体积大47毫升（95%置信区间，-9；104），但在针对脂肪百分比校正后，这一差异仅为4毫升（95%置信区间，-67；75）。成年组的乳房体积与早期和晚期PS组相当（成年组与早期PS组相比为27毫升[95%置信区间，-28；83]，成年组与晚期PS组相比为-20毫升[95%置信区间，-80；40]）。总体而言，68%的受试者对乳房大小满意（早期PS组为57%，晚期PS组为76%，成年组为70%）。
早期开始PS与更大的乳房体积无关，这表明青春期睾酮暴露在随后的GAHT后不影响乳房体积。尽管乳房尺寸有限，但大多数跨性别女性对其乳房发育感到满意。
