Bicalutamide Does Not Raise Transaminases Compared to Alternative Anti-Androgen Regimens Among Transfeminine Adolescents and Young Adults: A Retrospective Cohort Study

February 2024

Katie Burgener, Brian J. DeBosch, Jinli Wang, Christopher S. Lewis, Cynthia Herrick

bicalutamide anti-androgen androgen blockade estradiol transfeminine

TLDR Bicalutamide does not significantly affect liver enzymes and is a safe anti-androgen option for transfeminine individuals.

This retrospective cohort study evaluated the impact of low-dose bicalutamide on liver transaminases in 84 transfeminine adolescents and young adults, compared to 69 individuals using other androgen blockade methods. The study found no significant differences in changes or maximum levels of ALT and AST between the bicalutamide group and the comparison group, with no cases of transaminase levels exceeding 3 times the upper limit of normal. Estradiol doses and Tanner stages were similar across groups. The findings suggest that bicalutamide does not significantly affect liver transaminases and may be a safe anti-androgen option for transfeminine individuals with appropriate monitoring.

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