Gupta Pranav, Cunha Luisa Marin, Diego Daniela, Tangpricha Vin
Department of Pediatrics, Division of Endocrinology, Metabolism and Lipids, Emory University School of Medicine, Atlanta, Georgia; Department of Pediatrics, Division of Endocrinology, Children's Healthcare of Atlanta, Atlanta, Georgia.
Centro Universitário Lusíada - Faculdade de Ciências Médicas de Santos, Santos, São Paulo, Brazil.
Endocr Pract. 2024 Dec;30(12):1206-1211. doi: 10.1016/j.eprac.2024.09.007. Epub 2024 Sep 19.
Gender-affirming hormone therapy (GAHT) is often used by transgender and gender-diverse individuals to align their physical appearance with their gender identity. Discontinuation rates and factors leading to discontinuation of GAHT are not fully understood. We aimed to assess the continuation and discontinuation rates of GAHT and the factors leading to discontinuation of GAHT in a systematic review of the literature.
We searched PubMed from 2009 until April 01, 2024, for all published studies that described initiation, discontinuation, and reasons for discontinuation of GAHT. Studies were screened by 2 authors independently. We included 6 studies that met the inclusion and exclusion criteria published between 2021 and 2024.
Five studies reported GAHT discontinuation rates under 10%, whereas 1 study reported a discontinuation/lost to follow-up rate of 30.8%. Only 1 study was prospective, whereas all other studies were retrospective. Reasons for discontinuation of GAHT were described in only 2 studies. One study reported GAHT discontinuation primarily from external factors, whereas the other study suggested that GAHT discontinuation occurred due to change in gender identity.
Current data on discontinuation of GAHT show that the rates of GAHT discontinuation appear to be low and the reasons include both external pressures and internal change of gender identity. A better understanding of the internal and external pressures that impact the decision to continue GAHT is needed in future studies.
跨性别者和性别多样化个体常使用性别确认激素疗法（GAHT），以使自己的外貌与性别认同相符。GAHT的停药率以及导致停药的因素尚未完全明确。我们旨在通过对文献的系统评价，评估GAHT的持续使用和停药率以及导致GAHT停药的因素。
我们检索了2009年至2024年4月1日期间PubMed上所有描述GAHT起始、停药及停药原因的已发表研究。由两名作者独立筛选研究。我们纳入了2021年至2024年期间发表的6项符合纳入和排除标准的研究。
5项研究报告GAHT停药率低于10%，而1项研究报告停药/失访率为30.8%。只有1项研究是前瞻性的，其他所有研究均为回顾性的。只有2项研究描述了GAHT停药的原因。1项研究报告GAHT停药主要是由于外部因素，而另一项研究表明GAHT停药是由于性别认同的改变。
目前关于GAHT停药的数据表明，GAHT停药率似乎较低，原因包括外部压力和性别认同的内在变化。未来的研究需要更好地了解影响继续使用GAHT决策的内部和外部压力。
