title: Cross-Sex Hormone Treatment and Psychobiological Changes in Transsexual Persons: Two-Year Follow-Up Data.
abstract: To date, there are few studies investigating the impact of body changes induced by cross-sex hormonal treatment (CHT) on psychobiological well-being in gender-dysphoric persons (GDs).
  
  
  
  The objective of the study was to assess whether CHT-related body changes affect psychobiological well-being in GDs.
  
  
  
  A consecutive series of 359 GDs was considered for a cross-sectional section of the study. In addition, 54 GDs were studied in a 2-year follow-up. A physical examination was performed, including body mass index, waist circumference, and hair distribution. We also evaluated breast development and testis volume in male to female subjects and clitoris length in female to male. Subjects were asked to complete several psychometric measures for the assessment of body uneasiness, GD, and psychopathology levels. The evaluation was repeated 2 years prospectively.
  
  
  
  The following results were found: 1) GDs undergoing CHT reported significantly lower subjective levels of GD, body uneasiness, and depressive symptoms as compared with those without; 2) CHT-induced body modifications were significantly associated with a better psychological adjustment; 3) during CHT, GDs reported a significant reduction of general psychopathology, depressive symptoms, and subjective GD, whereas social and legal indicators of GD showed a significant increase across time; and 4) among body changes induced by CHT, only breast development and increased body mass index had a significant impact on psychopathology reduction across time in male to female subjects and female to male subjects, respectively.
  
  
  
  The aforementioned results support the efficacy of CHT intervention in improving subjective perception of one's own body, which was partially associated with objective changes.
authors.affiliation: Department of Experimental, Clinical, and Biomedical Sciences (A.D.F., G.C., J.R., P.H.C., E.C., C.S., E.F., A.M.L.A., E.B., M.Ma.), Sexual Medicine and Andrology Unit; Psychiatry Unit, Department of Neuroscience, Psychology, Drug Research and Child Health (V.R., G.C., E.C., C.S.), Department of Health Sciences University of Florence (D.D.), 50121 Florence, Italy; and Gender Identity Development Service (M.Mo.), Hospital S. Camillo-Forlanini, 00152 Rome, Italy.
authors.forename: Alessandra D
authors.initials: AD
authors.lastname: Fisher
authors.affiliation: Department of Experimental, Clinical, and Biomedical Sciences (A.D.F., G.C., J.R., P.H.C., E.C., C.S., E.F., A.M.L.A., E.B., M.Ma.), Sexual Medicine and Andrology Unit; Psychiatry Unit, Department of Neuroscience, Psychology, Drug Research and Child Health (V.R., G.C., E.C., C.S.), Department of Health Sciences University of Florence (D.D.), 50121 Florence, Italy; and Gender Identity Development Service (M.Mo.), Hospital S. Camillo-Forlanini, 00152 Rome, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Castellini
authors.affiliation: Department of Experimental, Clinical, and Biomedical Sciences (A.D.F., G.C., J.R., P.H.C., E.C., C.S., E.F., A.M.L.A., E.B., M.Ma.), Sexual Medicine and Andrology Unit; Psychiatry Unit, Department of Neuroscience, Psychology, Drug Research and Child Health (V.R., G.C., E.C., C.S.), Department of Health Sciences University of Florence (D.D.), 50121 Florence, Italy; and Gender Identity Development Service (M.Mo.), Hospital S. Camillo-Forlanini, 00152 Rome, Italy.
authors.forename: Jiska
authors.initials: J
authors.lastname: Ristori
authors.affiliation: Department of Experimental, Clinical, and Biomedical Sciences (A.D.F., G.C., J.R., P.H.C., E.C., C.S., E.F., A.M.L.A., E.B., M.Ma.), Sexual Medicine and Andrology Unit; Psychiatry Unit, Department of Neuroscience, Psychology, Drug Research and Child Health (V.R., G.C., E.C., C.S.), Department of Health Sciences University of Florence (D.D.), 50121 Florence, Italy; and Gender Identity Development Service (M.Mo.), Hospital S. Camillo-Forlanini, 00152 Rome, Italy.
authors.forename: Helen
authors.initials: H
authors.lastname: Casale
authors.affiliation: Department of Experimental, Clinical, and Biomedical Sciences (A.D.F., G.C., J.R., P.H.C., E.C., C.S., E.F., A.M.L.A., E.B., M.Ma.), Sexual Medicine and Andrology Unit; Psychiatry Unit, Department of Neuroscience, Psychology, Drug Research and Child Health (V.R., G.C., E.C., C.S.), Department of Health Sciences University of Florence (D.D.), 50121 Florence, Italy; and Gender Identity Development Service (M.Mo.), Hospital S. Camillo-Forlanini, 00152 Rome, Italy.
authors.forename: Emanuele
authors.initials: E
authors.lastname: Cassioli
authors.affiliation: Department of Experimental, Clinical, and Biomedical Sciences (A.D.F., G.C., J.R., P.H.C., E.C., C.S., E.F., A.M.L.A., E.B., M.Ma.), Sexual Medicine and Andrology Unit; Psychiatry Unit, Department of Neuroscience, Psychology, Drug Research and Child Health (V.R., G.C., E.C., C.S.), Department of Health Sciences University of Florence (D.D.), 50121 Florence, Italy; and Gender Identity Development Service (M.Mo.), Hospital S. Camillo-Forlanini, 00152 Rome, Italy.
authors.forename: Carolina
authors.initials: C
authors.lastname: Sensi
authors.affiliation: Department of Experimental, Clinical, and Biomedical Sciences (A.D.F., G.C., J.R., P.H.C., E.C., C.S., E.F., A.M.L.A., E.B., M.Ma.), Sexual Medicine and Andrology Unit; Psychiatry Unit, Department of Neuroscience, Psychology, Drug Research and Child Health (V.R., G.C., E.C., C.S.), Department of Health Sciences University of Florence (D.D.), 50121 Florence, Italy; and Gender Identity Development Service (M.Mo.), Hospital S. Camillo-Forlanini, 00152 Rome, Italy.
authors.forename: Egidia
authors.initials: E
authors.lastname: Fanni
authors.affiliation: Department of Experimental, Clinical, and Biomedical Sciences (A.D.F., G.C., J.R., P.H.C., E.C., C.S., E.F., A.M.L.A., E.B., M.Ma.), Sexual Medicine and Andrology Unit; Psychiatry Unit, Department of Neuroscience, Psychology, Drug Research and Child Health (V.R., G.C., E.C., C.S.), Department of Health Sciences University of Florence (D.D.), 50121 Florence, Italy; and Gender Identity Development Service (M.Mo.), Hospital S. Camillo-Forlanini, 00152 Rome, Italy.
authors.forename: Anna Maria Letizia
authors.initials: AM
authors.lastname: Amato
authors.affiliation: Department of Experimental, Clinical, and Biomedical Sciences (A.D.F., G.C., J.R., P.H.C., E.C., C.S., E.F., A.M.L.A., E.B., M.Ma.), Sexual Medicine and Andrology Unit; Psychiatry Unit, Department of Neuroscience, Psychology, Drug Research and Child Health (V.R., G.C., E.C., C.S.), Department of Health Sciences University of Florence (D.D.), 50121 Florence, Italy; and Gender Identity Development Service (M.Mo.), Hospital S. Camillo-Forlanini, 00152 Rome, Italy.
authors.forename: Eva
authors.initials: E
authors.lastname: Bettini
authors.affiliation: Department of Experimental, Clinical, and Biomedical Sciences (A.D.F., G.C., J.R., P.H.C., E.C., C.S., E.F., A.M.L.A., E.B., M.Ma.), Sexual Medicine and Andrology Unit; Psychiatry Unit, Department of Neuroscience, Psychology, Drug Research and Child Health (V.R., G.C., E.C., C.S.), Department of Health Sciences University of Florence (D.D.), 50121 Florence, Italy; and Gender Identity Development Service (M.Mo.), Hospital S. Camillo-Forlanini, 00152 Rome, Italy.
authors.forename: Maddalena
authors.initials: M
authors.lastname: Mosconi
authors.affiliation: Department of Experimental, Clinical, and Biomedical Sciences (A.D.F., G.C., J.R., P.H.C., E.C., C.S., E.F., A.M.L.A., E.B., M.Ma.), Sexual Medicine and Andrology Unit; Psychiatry Unit, Department of Neuroscience, Psychology, Drug Research and Child Health (V.R., G.C., E.C., C.S.), Department of Health Sciences University of Florence (D.D.), 50121 Florence, Italy; and Gender Identity Development Service (M.Mo.), Hospital S. Camillo-Forlanini, 00152 Rome, Italy.
authors.forename: Davide
authors.initials: D
authors.lastname: Dèttore
authors.affiliation: Department of Experimental, Clinical, and Biomedical Sciences (A.D.F., G.C., J.R., P.H.C., E.C., C.S., E.F., A.M.L.A., E.B., M.Ma.), Sexual Medicine and Andrology Unit; Psychiatry Unit, Department of Neuroscience, Psychology, Drug Research and Child Health (V.R., G.C., E.C., C.S.), Department of Health Sciences University of Florence (D.D.), 50121 Florence, Italy; and Gender Identity Development Service (M.Mo.), Hospital S. Camillo-Forlanini, 00152 Rome, Italy.
authors.forename: Valdo
authors.initials: V
authors.lastname: Ricca
authors.affiliation: Department of Experimental, Clinical, and Biomedical Sciences (A.D.F., G.C., J.R., P.H.C., E.C., C.S., E.F., A.M.L.A., E.B., M.Ma.), Sexual Medicine and Andrology Unit; Psychiatry Unit, Department of Neuroscience, Psychology, Drug Research and Child Health (V.R., G.C., E.C., C.S.), Department of Health Sciences University of Florence (D.D.), 50121 Florence, Italy; and Gender Identity Development Service (M.Mo.), Hospital S. Camillo-Forlanini, 00152 Rome, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Maggi
mesh_terms: D000328:Adult; D000886:Anthropometry; D001828:Body Image / Q000523:psychology*; D003430:Cross-Sectional Studies; D003863:Depression / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D000068116:Gender Dysphoria / Q000188:drug therapy* / Q000523:psychology*; D012739:Gonadal Steroid Hormones / Q000008:administration & dosage / Q000494:pharmacology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010549:Personal Satisfaction; D014189:Transsexualism / Q000523:psychology*
chemical_list: D012739:Gonadal Steroid Hormones