Milionis Charalampos, Barouti Konstantina, Papadopoulou Vassiliki, Pouliasi Foteini, Karlafti Efthymia, Makrydima Sofia, Karampa Stavroula, Venaki Evaggelia, Koukkou Eftychia
General Hospital 'Elena Venizelou', Athens, Attica, Greece.
Sex Health. 2025 Aug;22. doi: 10.1071/SH25113.
Background Gender incongruence results from the mismatch between gender identity and thesex assigned at birth. The process of gender affirmation includes a series of procedures during which the transgender individual acquires phenotypic features of the desired sex. Hormonal therapy for transgender women aims to suppress endogenous androgens and replace them with estrogens. The present study sought to investigate the safety of feminizing therapy in transgender women in relation to somatometric and metabolic parameters. Methods The medical records of transgender women who received oral estradiol valerate and a gonadotropin-releasing hormone (GnRH) agonist for at least 18months were reviewed. The study population had estradiol levels within the normal limits of the follicular phase of cisgender women of reproductive age and suppressed blood testosterone levels after 18months of treatment. Changes in body mass index, glycemic and lipid profiles, hemoglobin and hematocrit, and liver function tests were examined. The paired t -test was used for statistical analysis. Results The mean blood estradiol and testosterone levels after approximately 18months of treatment were 85.65pg/mL and 24ng/dL, respectively. There was a statistically significant increase in blood triglycerides as well as a statistically significant decrease in hemoglobin and hematocrit. However, none of the participants developed severe hypertriglyceridemia or anemia. No significant changes were found in blood cholesterol (total, high-density lipoprotein, and low-density lipoprotein cholesterol), glucose, and liver enzymes. Conclusions Treatment with oral estradiol valerate and an intramuscular GnRH agonist is used in daily clinical practice to promote feminizing physical changes in transgender women. However, the possibility of side effects is not well documented. The present study demonstrated that achieving estradiol and testosterone levels within therapeutic targets is important for the safety of gender-affirming therapy.
背景 性别不一致是由性别认同与出生时所指定的性别不匹配所致。性别确认过程包括一系列程序，在此过程中，跨性别者获得期望性别的表型特征。针对跨性别女性的激素治疗旨在抑制内源性雄激素并用雌激素替代它们。本研究旨在调查跨性别女性女性化治疗在身体测量和代谢参数方面的安全性。方法 回顾了接受口服戊酸雌二醇和促性腺激素释放激素（GnRH）激动剂至少18个月的跨性别女性的病历。研究人群的雌二醇水平在育龄顺性别女性卵泡期的正常范围内，且治疗18个月后血液睾酮水平受到抑制。检查了体重指数、血糖和血脂谱、血红蛋白和血细胞比容以及肝功能测试的变化。采用配对t检验进行统计分析。结果 治疗约18个月后的平均血液雌二醇和睾酮水平分别为85.65pg/mL和24ng/dL。血液甘油三酯有统计学意义的升高，血红蛋白和血细胞比容有统计学意义的降低。然而，没有参与者出现严重高甘油三酯血症或贫血。血液胆固醇（总胆固醇、高密度脂蛋白胆固醇和低密度脂蛋白胆固醇）、葡萄糖和肝酶没有发现显著变化。结论 在日常临床实践中，使用口服戊酸雌二醇和肌肉注射GnRH激动剂来促进跨性别女性的女性化身体变化。然而，副作用的可能性记录并不充分。本研究表明，使雌二醇和睾酮水平达到治疗目标对性别确认治疗的安全性很重要。
