GKT School of Medical Education, King's College London, London, UK.
Psychiatry, The Tavistock and Portman NHS Foundation Trust, London, UK.
Ann Med. 2024 Dec;56(1):2406447. doi: 10.1080/07853890.2024.2406447. Epub 2024 Oct 9.
There is increasing evidence that gender dysphoria (GD) is more prevalent in the Klinefelter Syndrome (KS) population than in males in the general population; however, the exact incidence is uncertain. The aim of this study was to further explore the prevalence of gender-related issues, the role that physical characteristics play in gender identity, and the issues surrounding Hormone Replacement Therapy (HRT) in KS.
As part of a registered Quality Improvement Project (QIP), one online 23-point questionnaire on KS patient attitudes toward gender identity was shared with members of the Klinefelter Syndrome Association (KSA). In total, 139 anonymous responses were collected between December 2021 and January 2023. The questionnaire was developed with the guidance of multiple clinicians (including gender psychiatrists, urologists, psychosexual medicine specialists, and endocrinologists) and patient Delphi rounds. Data was reviewed and analyzed by 4 independent researchers within the QIP team.
Only 53% of KS patients responding to this survey fully identified as male and 19% stated that they did not enjoy living as the sex on their birth certificate, with 43% considering changing aspects of their physical appearance to better match their gender. Regarding HRT, 67% of respondents were receiving Testosterone Replacement Therapy (TRT). 63% wanted TRT and 17% wanted estrogen, including 6% of TRT users who would prefer estrogen instead. 36% that were currently receiving TRT did not identify as male, and 3 participants stated that they have GD.
These results indicate that a significant proportion of KS patients do not fully identify with the male gender and are unhappy living as the sex on their birth certificate. Although TRT worked for most, its use should be discussed carefully with those with gender identity concerns.
越来越多的证据表明，性别焦虑症（GD）在克莱恩费尔特综合征（KS）患者中的发病率高于普通男性人群；然而，确切的发病率尚不确定。本研究旨在进一步探讨与性别相关问题的患病率、身体特征在性别认同中的作用，以及 KS 患者激素替代治疗（HRT）的相关问题。
作为注册质量改进项目（QIP）的一部分，我们向 Klinefelter 综合征协会（KSA）成员分享了一份关于 KS 患者对性别认同态度的在线 23 点问卷。共收集到 2021 年 12 月至 2023 年 1 月期间的 139 份匿名回复。问卷是在多位临床医生（包括性别精神病学家、泌尿科医生、性医学专家和内分泌学家）和患者德尔菲轮次的指导下开发的。QIP 团队的 4 位独立研究人员对数据进行了审查和分析。
只有 53%的 KS 患者完全认同自己的男性身份，19%的患者表示他们不喜欢以出生证明上的性别生活，43%的患者考虑改变身体特征以更好地匹配自己的性别。关于 HRT，67%的受访者正在接受睾酮替代治疗（TRT）。63%的人想要 TRT，17%的人想要雌激素，包括 6%的 TRT 用户更喜欢雌激素。36%正在接受 TRT 的人不认同自己是男性，有 3 名参与者表示他们患有 GD。
这些结果表明，相当一部分 KS 患者不完全认同男性性别，不喜欢以出生证明上的性别生活。尽管 TRT 对大多数人有效，但对于有性别认同问题的人，应该谨慎讨论其使用。
