Gender-Affirming Hormone Therapy for Transgender Men

The document from December 2018 provides a comprehensive overview of gender-affirming hormone therapy for transgender men, addressing the lack of knowledgeable providers and the role of obstetricians and gynecologists in care. It estimates 1.4 million transgender adults in the United States and discusses testosterone therapy protocols, which are extrapolated from those used for hypogonadal cisgender men, despite the absence of high-quality, long-term studies on their effectiveness and safety. The document outlines various testosterone formulations, administration routes, and adjunctive hormonal therapies, as well as expected physical changes and potential side effects. It emphasizes the importance of regular monitoring and a multidisciplinary approach to care, including mental health support and fertility preservation discussions. The document also reviews the literature on the health effects of hormone therapy, including cardiovascular health, bone density, reproductive systems, and cancer risk, and highlights the need for further research on long-term effects. It concludes that while testosterone therapy appears safe and effective with proper care, there is a lack of high-quality, long-term, large-scale studies, and that obstetricians and gynecologists can play a valuable role in providing evidence-based care for transgender individuals.