June 02, 2018
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New developments changing transgender health care

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As transgender medicine continues to grow as a subspecialty, new research is rapidly changing the treatment landscape. Today, more adolescents are comfortable visiting an endocrinologist to discuss the initiation of cross-sex hormone therapy — some before reaching puberty — raising new questions and considerations about therapies that have not been studied long-term. Additionally, midlife transgender patients considering gender-affirming HT or gender-confirmation surgeries must also confront a host of issues, including the potential side effects of estrogen or testosterone and the importance of continuing cancer screenings.

Recently, new studies with longer follow-up have demonstrated that long-term estrogen plus spironolactone therapy in transgender women and testosterone therapy in transgender men does not affect prolactin or estradiol levels, respectively, suggesting that the therapies are safe in these populations. For transgender adolescents, new research reveals that many patients are willing to forego fertility preservation to begin HT as soon as possible.

As a courtesy to its readers, Endocrine Today compiled a list of the latest news in transgender health care posted on Healio.com.

Few transgender teens opt to delay HT to preserve fertility

Most transgender and gender-nonconforming adolescents do not consider fertility preservation an important reason to delay the start of hormone therapy, but some cite parental attitudes regarding biological offspring as influencing any decision regarding treatment, according to survey data presented at the Pediatric Academic Societies Meeting.

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Estrogen plus spironolactone therapy not associated with prolactin levels in transgender women

Transgender women on a long-term regimen of estrogen and spironolactone therapy did not experience a clinically relevant change in prolactin level, suggesting the therapy combination is safe in this population, according to findings from a retrospective study published in Endocrine Practice.

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Brain structure of transgender teens resembles their desired gender

Teenagers with gender dysphoria have brain structures and responses that are similar to that of their experienced gender rather than their birth sex, according to research presented at the European Society of Endocrinology annual meeting.

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Examination of breast tissue recommended after gender-confirming mastectomy

An unexpected case of breast cancer in a transgender man undergoing gender-confirming mastectomy highlights the importance of histopathological examination of mastectomy specimens, according to researcher published in the British Journal of Surgery.

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Testosterone therapy in transgender men does not affect estradiol levels

Transgender men treated with testosterone therapy did not experience increases in estradiol levels after 6 years of follow-up, but BMI decreased with increasing testosterone levels, according to findings published in Endocrine Practice.

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