SUN-144: Initiating Estradiol Hormone Therapy in a Transgender Woman With Multifocal Idiopathic Localization-Related Epilepsy
October 2025
in “
Journal of the Endocrine Society
”
New to Estradiol? There is a guide in the encyclopedia. Read the guide → Studysummary In this case report, a transgender woman with refractory epilepsy began estrogen therapy for gender-affirming purposes, experiencing stable epilepsy and reduced gender dysphoria through ongoing multidisciplinary care, highlighting the importance of careful management for similar patients. Our plain-language summary of this paper — not a Tressless recommendation.
This case study reports on a 51-year-old transgender woman with refractory multifocal idiopathic localization-related epilepsy who initiated estradiol (E2) hormone therapy as part of gender-affirming hormone therapy (GAHT). Despite the known epileptogenic effects of estrogen, the patient started on a low-dose transdermal E2 patch, which was gradually increased. Over the course of a year, she experienced physical changes such as breast enlargement, softer skin, and less unwanted hair growth, with some fluctuations in seizure frequency. Her testosterone levels were significantly suppressed, and she expressed satisfaction with the reduction in gender dysphoria. The study emphasizes the importance of multidisciplinary care and careful monitoring when initiating GAHT in transgender patients with epilepsy, highlighting that the patient's epilepsy remained overall stable with continued management.
