Journal article
Transgender patients and gender-affirming hormone therapy through the mid-life
Maturitas, v 189, 108093
Nov 2024
PMID: 39178607
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
•Transgender and gender-diverse (TGD) patients are an understudied population through mid-life.•Risks surrounding gender-affirming hormone therapy (GAHT) in the aging population have not been as vigorously studied as they have been for younger people.•Understanding the risks of GAHT through mid-life will help clinicians guide TGD patients during this time.
The menopause transition and post-menopause period marks a time of dynamic physiological and hormonal change. Cisgender women commonly experience vasomotor symptoms, genitourinary symptoms, and changes in bone health. The transgender population, including those assigned female at birth (AFAB) and those assigned male at birth (AMAB), has been understudied in terms of experiences through the menopause transition and midlife. Additionally, there is no formal recommendation or guidance on continuation of gender-affirming hormone therapy (GAHT) through midlife. While gender-affirming therapies for transgender patients are well defined and supported by organizational guidelines, including from the World Professional Association for TGD Health (WPATH) (Standards of Care 8, SOC8) and from the Endocrine Society (2017), evidence on continuation of therapy and dose adjustments into mid-life are lacking. Data from a few large cohort studies and small cross-sectional studies suggest increased risk of venous thromboembolism (VTE), stroke and myocardial infarction in those AMAB on GAHT. For those AFAB on testosterone therapy, risks of cardiovascular disease and stroke and to bone health are not well defined, given inconsistent findings from large cohort studies. Currently, the decision to continue GAHT for transgender patients is guided by patient preference along with clinician guidance. Further research is warranted regarding risks of continuing GAHT into mid-life for both AMAB and AFAB patients. Given the significant benefit of GAHT in this population, however, this data would be most helpful for counseling on risks along with appropriate monitoring and prevention for related morbidities during mid-life in the setting of GAHT use.
Metrics
Details
- Title
- Transgender patients and gender-affirming hormone therapy through the mid-life
- Creators
- Jaya M. Mehta - Allegheny General HospitalSarah Kanell - Allegheny General HospitalCharlie E.A. Borowicz - Allegheny Health NetworkMolly Ainsman Fisher - Allegheny General Hospital
- Publication Details
- Maturitas, v 189, 108093
- Publisher
- Elsevier
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- General Internal Medicine
- Web of Science ID
- WOS:001301101900001
- Scopus ID
- 2-s2.0-85201756480
- Other Identifier
- 991021937807904721
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InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Web of Science research areas
- Geriatrics & Gerontology
- Obstetrics & Gynecology