Testosterone Therapy for Transgender Men: Effects and Safety

The document from April 1, 2017, reviews the effects and safety of testosterone therapy in transgender men. It outlines the desired effects such as increased facial and body hair, muscle mass, and deepened voice, as well as psychological benefits like reduced gender dysphoria and depression. However, it also notes undesired effects including acne, alopecia, and potential increases in cardiovascular risks. A prospective study of 53 transgender men found a 17% incidence of androgenetic alopecia after 1 year of treatment. Testosterone therapy led to cessation of menstruation in 86-97% of 138 transgender men within 6 months. It also affected reproductive organs and was associated with a lower incidence of breast cancer. While testosterone therapy appears safe in the short term, it can affect cholesterol levels, blood pressure, and potentially increase the risk of diabetes and metabolic syndrome. A Swedish study found similar mortality rates between transgender men who had hormone therapy and surgery and matched controls in the first 10 years, but increased mortality in transgender men after 10 years. The document emphasizes the need for more research, especially larger and longer prospective studies, to understand the long-term effects of testosterone therapy in transgender men.