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This study found that neonatal blocking of androgen and estrogen pathways in rats altered sex-specific expression of estrogen and androgen receptors in adult pituitary and adrenal glands, potentially influencing lifelong neuroendocrine function.

In this case report, a 25-year-old transgender woman on testosterone-blocking therapy developed generalised hypertrichosis after starting ciclosporin for severe plaque psoriasis, illustrating that ciclosporin can induce this side effect even under androgen suppression.

In this retrospective chart review, researchers observed that estrogen monotherapy effectively suppressed testosterone levels below 50ng/dL in all transfeminine patients studied, particularly those using injectable formulations, though the small sample size and ongoing data collection limit these findings.

In this retrospective study, among transfeminine patients aged 19-81 receiving gender-affirming estrogen therapy, 100% achieved testosterone suppression without anti-androgens when serum estradiol exceeded 100pg/mL, predominantly using injectable estrogen.

The guideline recommends mental health involvement in diagnosing gender identity disorder and outlines hormone and surgical treatment protocols, emphasizing safety, informed consent, and long-term monitoring.