Castelijn Jade M, Huisman Bodi, Steensma Thomas D, Wensing-Kruger S Annelijn, Kreukels Baudewijntje P C, den Heijer Martin, Dreijerink Koen M A
Amsterdam UMC, location VU University, Center of Expertise on Gender Dysphoria, Amsterdam, The Netherlands.
Endocrine. 2025 Aug 13. doi: 10.1007/s12020-025-04381-x.
Current guidelines for gender-affirming hormone therapy (GAHT) primarily focus on binary transgender (BT) individuals and provide limited recommendations for non-binary and genderqueer (NBGQ) individuals. Understanding hormone use among this heterogenous group will contribute to more personalized counseling and treatment strategies. We performed a systematic review of the scientific literature to assess the prevalence of GAHT in NBGQ individuals and potential clinical context-dependent differences.
A systematic literature search was performed aimed to assess the prevalence and type of GAHT use in NBGQ and BT individuals according to Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines, using PubMed, Embase and Web of Science databases.
Sixteen eligible articles were identified. All were retrospective cohort series published between 2018-2024, including a total of 1948 NBGQ individuals and 3991 BT individuals. Hormone use varied from 4-93% in NBGQ individuals and from 52-95% among BT individuals. Overall, significantly fewer NBGQ individuals were on GAHT compared to BT individuals, except those referred to gender-affirming care clinics. GAHT was more frequent in clinical cohorts compared with non-clinical cohorts, both among NBGQ (OR 6.4; CI 5.1-8.0) and BT (OR 3.1; CI 2.6-3.8) individuals. There was insufficient Information in the literature to be able to draw conclusions with regard to differences in types of GAHT.
The systematic review confirms that GAHT is less common in NBGQ compared with BT individuals. Hormone use is more frequent among NBGQ individuals seeking care in a clinical setting. These results highlight the heterogeneity in NBGQ as well as BT individuals with regard to treatment needs. Caregivers, in particular in clinical settings, should be aware that not all NBGQ individuals seek GAHT. Additional studies are needed to further explore tailored endocrine treatment needs in NBGQ individuals.
当前的性别肯定激素治疗（GAHT）指南主要关注二元跨性别者（BT），对非二元和性别酷儿（NBGQ）个体的建议有限。了解这一异质性群体中的激素使用情况将有助于制定更个性化的咨询和治疗策略。我们对科学文献进行了系统综述，以评估NBGQ个体中GAHT的患病率以及潜在的临床背景相关差异。
根据系统评价和Meta分析的首选报告项目（PRISMA）指南，使用PubMed、Embase和Web of Science数据库进行系统文献检索，旨在评估NBGQ和BT个体中GAHT的使用患病率和类型。
共识别出16篇符合条件的文章。所有文章均为2018年至2024年发表的回顾性队列系列，共纳入1948名NBGQ个体和3991名BT个体。NBGQ个体的激素使用率在4%至93%之间，BT个体的激素使用率在52%至95%之间。总体而言，与BT个体相比，接受GAHT的NBGQ个体明显较少，但转诊至性别肯定护理诊所的个体除外。在临床队列中，GAHT在NBGQ个体（OR 6.4；CI 5.1 - 8.0）和BT个体（OR 3.1；CI 2.6 - 3.8）中都比非临床队列更频繁。文献中没有足够的信息能够就GAHT类型的差异得出结论。
系统综述证实，与BT个体相比，GAHT在NBGQ个体中不太常见。在临床环境中寻求护理的NBGQ个体中激素使用更频繁。这些结果凸显了NBGQ个体以及BT个体在治疗需求方面的异质性。护理人员，尤其是在临床环境中的护理人员，应意识到并非所有NBGQ个体都寻求GAHT。需要进一步的研究来进一步探索NBGQ个体量身定制的内分泌治疗需求。
