Gender-Affirming Hormone Therapy for Transgender and Gender-Diverse Adults in Australia

July 2024 in “ Internal Medicine Journal ”

Brendan J. Nolan, Ada S. Cheung

gender-affirming hormone therapy testosterone therapy androgenic alopecia finasteride estradiol therapy venous thromboembolism cardiovascular risks bone health breast cancer GAHT Propecia

Studysummary This narrative review discusses the initiation and monitoring of gender-affirming hormone therapy in Australia, noting standard testosterone use for trans men and estradiol with anti-androgens for trans women, emphasizing the importance of monitoring cardiovascular and bone health.

Our plain-language summary. Not medical advice or a treatment recommendation. Consult a qualified healthcare professional before changing treatment. Full disclaimer

The document reviews gender-affirming hormone therapy (GAHT) for transgender and gender-diverse adults in Australia, highlighting the informed consent model's prevalence and high patient satisfaction. It details testosterone therapy for individuals assigned female at birth, noting physical changes and adverse effects like acne and androgenic alopecia, with limited data on treatments such as finasteride. Estradiol therapy for feminization involves monitoring serum levels and carries risks like venous thromboembolism, though modern regimens are safer. GAHT improves gender incongruence and mental health but increases cardiovascular risks, necessitating proactive management. Bone health concerns are addressed, with improvements seen post-therapy. Cancer screening should be anatomy-specific, with estradiol users having higher breast cancer rates than cisgender men. Individualized care and education are emphasized for safe and effective GAHT.

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Research cited in this study

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research Effect of Gender-Affirming Hormone Therapy on Hair Growth: A Systematic Review of the Literature

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This systematic review reported that gender-affirming hormone therapy may lead to changes in hair growth patterns, with differing effects for transgender men and women, potentially impacting quality of life.

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11 citations , November 2022 in “Journal of Endocrinological Investigation”

In this study, gender-affirming hormonal treatment was associated with increased hair growth, acne, and alopecia prevalence in transgender individuals assigned female at birth, while opposite dermatological changes were observed in those assigned male at birth.

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59 citations , February 2021 in “BMJ”

This study found a strong dose-related increase in the risk of intracranial meningiomas associated with high doses of cyproterone acetate, with some reduction in risk after stopping the treatment.

research Cross-Sex Hormone Therapy in Australia: The Prescription Patterns of Clinicians Experienced in Adult Transgender Healthcare

15 citations , February 2019 in “Internal Medicine Journal”

This study found that experienced Australian prescribers of hormone therapy for transgender adults often follow international guidelines but highlight the need for better training and specific local guidelines.

research Endocrine Treatment of Gender-Dysphoric/Gender-Incongruent Persons: An Endocrine Society Clinical Practice Guideline

2170 citations , September 2017 in “The Journal of Clinical Endocrinology & Metabolism”

This updated guideline from the Endocrine Society highlights the importance of endocrinologists in providing safe and effective hormone regimens for gender-affirming care, especially for adolescents who have entered puberty.

Cross-Sex Hormone Therapy in Trans Persons Is Safe and Effective at Short-Term Follow-Up: Results from the European Network for the Investigation of Gender Incongruence

research Cross-Sex Hormone Therapy in Trans Persons Is Safe and Effective at Short-Term Follow-Up: Results from the European Network for the Investigation of Gender Incongruence

204 citations , May 2014 in “The Journal of Sexual Medicine”

This study concluded that current cross-sex hormone treatments for trans men and trans women are effective with a low risk of side effects in the short term, though they did observe specific clinical changes.

research Short- and Long-Term Clinical Skin Effects of Testosterone Treatment in Trans Men

110 citations , October 2013 in “The Journal of Sexual Medicine”

This study found that testosterone therapy in trans men increased facial and body hair growth while the prevalence and severity of acne peaked at 6 months but were primarily mild after long-term treatment.

research Standards of Care for the Health of Transsexual, Transgender, and Gender-Nonconforming People, Version 7

2295 citations , August 2012 in “The international journal of transgenderism/International journal of transgenderism”

This publication reviews the World Professional Association for Transgender Health's Standards of Care for supporting transgender and gender nonconforming people, with adjustments needed for diverse global contexts and no new clinical results.