TLDR Gender-affirming hormone therapy affects health risks and requires careful management, especially as transgender individuals age.
This narrative review discusses the impact of gender affirming hormone therapy (GAHT) on transgender health, particularly in relation to aging and menopause. GAHT, often used lifelong, helps achieve sex steroid levels of the affirmed gender, making menopause less relevant for transgender individuals. However, feminizing hormone therapy increases risks of venous thromboembolism, myocardial infarction, stroke, and osteoporosis, while masculinizing therapy raises risks of polycythemia, myocardial infarction, and poorly understood pelvic pain. Proactive cardiovascular risk management and bone health optimization are crucial. Due to limited research on GAHT in older age, a shared decision-making approach is advised to balance individual goals and potential adverse effects.
19 citations
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February 2021 in “Journal of Clinical Investigation” More research is needed on the health effects of hormone therapy for transgender and nonbinary people.
31 citations
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September 2020 in “Clinical endocrinology” Some antiandrogens may lower testosterone better than others, but it's unclear which is best for feminization in transgender women; more research is needed.
57 citations
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December 2018 in “JAMA Surgery” Hormone treatment for transgender patients may not need to be stopped before surgery, but more research is needed, especially on estrogen.
2170 citations
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September 2017 in “The Journal of Clinical Endocrinology & Metabolism” A multidisciplinary approach is crucial for safe and effective hormone treatment in gender-dysphoric individuals, with specific guidelines for adolescents and adults.
June 2023 in “Clinical and Experimental Dermatology” Gender-affirming hormone therapy changes hair growth in transgender people, with feminizing therapy reducing hair and masculinizing therapy increasing it, but sometimes additional treatment is needed.
October 2024 in “Journal of the Endocrine Society” Feminizing hormone therapy increases kidney filtration rate.
February 2023 in “Journal of The American Academy of Dermatology” Transgender patients on masculinizing hormones have higher hair loss rates than cisgender women.
July 2023 in “The Journal of Clinical Endocrinology and Metabolism” Gender-affirming hormone therapy improves physical performance in trans men to the level of cisgender men, while in trans women, it increases fat mass and decreases muscle mass, with no advantage in physical performance after 2 years.
May 2023 in “Journal of drugs in dermatology” Most transgender patients getting laser hair removal before gender-affirming surgery are already on hormone therapy, which might affect the hair removal process.
