Long-term evaluation of cross-sex hormone treatment in transsexual persons.
BACKGROUND
Long-term effects and side effects of cross-sex hormone treatment in transsexual persons are not well known.


OBJECTIVE
The aim of this study is to describe the effects and side effects of cross-sex hormone therapy in both transsexual men and women.


METHODS
Hormone levels were measured by immunoassays. Physical health was assessed by physical examination and questionnaires on general health and specific side effects, areal bone parameters by dual energy X-ray absorptiometry.


METHODS
Single center cross-sectional study in 100 transsexual persons post-sex reassignment surgery and on average 10 years on cross-sex hormone therapy.


RESULTS
Transsexual men did not experience important side effects such as cardiovascular events, hormone-related cancers, or osteoporosis. In contrast, a quarter of the transsexual women had osteoporosis at the lumbar spine and radius. Moreover, 6% of transsexual women experienced a thromboembolic event and another 6% experienced other cardiovascular problems after on average 11.3 hormone treatment years. None of the transsexual women experienced a hormone-related cancer during treatment.


CONCLUSIONS
Cross-sex hormone treatment appears to be safe in transsexual men. On the other hand, a substantial number of transsexual women suffered from osteoporosis at the lumbar spine and distal arm. Twelve percent of transsexual women experienced thromboembolic and/or other cardiovascular events during hormone treatment, possibly related to older age, estrogen treatment, and lifestyle factors. In order to decrease cardiovascular morbidity, more attention should be paid to decrease cardiovascular risk factors during hormone therapy management.
Department of Endocrinology, University Hospital Ghent, Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium. katrien.wierckx@ugent.be
Katrien
K
Wierckx
Sven
S
Mueller
Steven
S
Weyers
Eva
E
Van Caenegem
Greet
G
Roef
Gunter
G
Heylens
Guy
G
T'Sjoen
D015502:Absorptiometry, Photon; D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D012739:Gonadal Steroid Hormones / Q000009:adverse effects / Q000097:blood / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011795:Surveys and Questionnaires; D063106:Transgender Persons; D014189:Transsexualism / Q000188:drug therapy*; D055815:Young Adult
D012739:Gonadal Steroid Hormones