Tracking Epigenetic Biomarkers of Health and Aging During the Initial Year of Gender-Affirming Hormone Therapy.

Gender-affirming hormone therapy (GAHT) is a necessary treatment for many transgender people, and there is a critical need to further improve treatment experience and mitigate possible risks. Here we investigated whether DNA methylation (DNAm) biomarkers of health and aging are modified during the first year of GAHT and whether these vary by treatment type. Cohort consisted of 13 trans women (TW) and 13 trans men (TM).

Epigenetic remodeling by sex hormone receptors and implications for gender affirming hormone therapy.

Sex differences in immune system development and response to pathogens has been well documented, with females exhibiting more favorable outcomes for certain infections but a higher incidence of autoimmune disease compared to males. At least some of these sex differences are mediated by sex hormones, which signal through sex hormone receptors to remodel the regulatory chromatin landscape of cells. Here, we summarize the current knowledge of how sex hormone receptors remodel chromatin structure and epigenetic marks in different contexts in humans.

Serum Estradiol Concentrations With Estradiol 0.06% Gel in Transgender and Gender-Diverse Adults.

Objective: Transgender and gender-diverse individuals undergoing estradiol therapy for gender affirmation are typically treated with oral or transdermal estradiol, with transdermal estradiol recommended for those aged > 45 years. There are limited data evaluating estradiol gel in gender-affirming hormone therapy regimens. We aimed to assess the serum estradiol concentrations achieved with estradiol 0.

Laboratory Monitoring in Transgender and Gender-Diverse Individuals.

Background: Increasing numbers of transgender and gender-diverse individuals are seeking initiation of gender-affirming hormone therapy. This aligns an individual's physical characteristics with their gender identity and improves psychological outcomes. Physical changes, including changes to muscle mass and body fat redistribution, can alter sex-specific laboratory reference ranges.

Estradiol Concentrations and Wellbeing in Trans People Using Estradiol Hormone Therapy.

Purpose: In trans people undergoing feminizing hormone therapy, optimal estradiol concentrations are unclear, and anecdotally, some individuals desire supraphysiologic estradiol concentrations. We aimed to assess associations between estradiol concentration and psychological distress, well-being, and dysphoria. Second, we aimed to explore relationships between estradiol concentration and the risk of medical conditions potentially associated with estradiol therapy.

Effect of bicalutamide on serum total testosterone concentration in transgender adults: a case series.

Background: There is interest in repurposing bicalutamide for gender-affirming hormone therapy, but little data regarding efficacy and safety in the transgender population.

Objectives: To determine the effect of bicalutamide on serum total testosterone concentrations and liver function. Given bicalutamide is a pure androgen receptor antagonist, we hypothesized that serum total testosterone concentrations would be higher than the cisgender female reference range and those recommended for transgender individuals in consensus guidelines.

Exploring the role of sex hormones and gender diversity in multiple sclerosis.

Sex and sex hormones are thought to influence multiple sclerosis (MS) through effects on inflammation, myelination and neurodegeneration, and exogenous hormones have been explored for their therapeutic potential. However, our understanding of how sex hormones influence MS disease processes and outcomes remains incomplete. Furthermore, our current knowledge is derived primarily from studies that focus exclusively on cisgender populations with exclusion of gender-diverse people.

Effect of Spironolactone and Cyproterone Acetate on Breast Growth in Transgender People: A Randomized Clinical Trial.

Context: Transgender people with sex recorded male at birth desiring feminization commonly use cyproterone acetate or spironolactone as antiandrogens with estradiol, but the optimal antiandrogen is unclear.

Objective: We aimed to assess the effect of antiandrogens on breast development. We hypothesized this would be greater in those treated with cyproterone acetate than spironolactone due to more potent androgen receptor antagonism and suppression of serum total testosterone concentrations.

Validation of Breast Idea Volume Estimator Application in Transfeminine People.

Background: Accurate estimation of breast volume is important as researchers aim to achieve optimal feminization for transfeminine people. The Breast Idea Volume Estimator (BIVE) application allows estimation of breast volume using two-dimensional (2D) photographs but has not been validated in the chests of people who have undergone testosterone-mediated puberty.

Methods: To estimate breast volume, clinical photographs and 3D scans were collected at baseline and 6 months, as a prespecified secondary outcome of a randomized clinical trial of antiandrogen therapy in transfeminine people commencing hormone therapy.

Peri-operative care of transgender and gender-diverse individuals: guidance for clinicians and departments.

Introduction: The objective of this document is to guide best practice to ensure the safety and dignity of transgender and gender-diverse people in the peri-operative period. While transgender and gender-diverse people may have specific health needs in relation to gender dysphoria, their health requirements go beyond their gender identity. Most doctors will provide care to someone who is transgender or gender-diverse at some stage in their career.

Epidemiology of Intensive Care Patients Classified as a Third Sex in Australia and New Zealand.

Background: Patient sex affects treatment and outcomes in critical illness. Previous studies of sex differences in critical illness compared female and male patients. In this study, we describe the group of patients classified as a third sex admitted to ICUs in Australia and New Zealand.