ECE2016 Eposter Presentations Steroid metabolism + action (13 abstracts)
Endocrinological approach of individuals with gender dysphoria (transsexuality): experience of a large center
Diana Martins 1 , Margarida Bastos 1, , Carla Baptista 1 , Lígia Fonseca 2, , Graça Santos 2, , Giselda Carvalho 3, , Francisco Rolo 4, , Susana Pinheiro 5, , Daniela Guelho 1 , Nuno Vicente 1 , Luís Cardoso 1 , Diana Oliveira 1 , Adriana Lages 1 , Mara Ventura 1 & Francisco Carrilho 1
1Endocrinology, Diabetes and Metabolism Department of Coimbra University Hospital Centre, Coimbra, Portugal; 2Psychiatry Department of Coimbra University Hospital Centre, Coimbra, Portugal; 3Gynecology Department of Coimbra University Hospital Centre, Coimbra, Portugal; 4Urology and Renal Transplantation Department of Coimbra University Hospital Centre, Coimbra, Portugal; 5Plastic Surgery Department of Coimbra University Hospital Centre, Coimbra, Portugal; 6Genitourinary and Sexual Reconstruction Unit of Coimbra Hospital and University Centre, Coimbra, Portugal.
Introduction:: Gender dysphoria (GD) is featured by significant difference between the individual’s expressed gender and the gender others would assign him or her, with marked distress in social and occupational functionality, according to DSM-V classification. We report the experience in the clinical evaluation and the results of hormonal therapy and sex reassignment surgery in a hospital center.
Methods:: It was conducted a retrospective analysis of 85 patients with GD, referred for clinical and psychological evaluation, hormone therapy and sex reassignment surgery (SRC) at the Genitourinary and Sexual Reconstruction Unit of Coimbra Hospital and University Centre (Portugal).
Results:: Since 2004, a total of 85 patients, 47 female-to-male (FTM) and 38 male-to-female (MTF) were evaluated. The number of patients seeking treatment has increased substantially in the last 5 years. Age at initial endocrinology evaluation: 29.29±11.60 years, significantly lower (P<0.001) in the FTM group.
These patients had a high prevalence of mental health and psychiatric problems, over 30% (N=26) and other important associated pathology were evaluated (multinodular goiter, neoplasia, diabetes, karyotype alterations and infectious diseases).
Sixty-three patients (74.1%) started hormonal treatment without significant complications (prior self-medication in 12.9%). Thirty-seven patients (43.5%) undergone sex-reassignment surgery, without significant differences between MTF and FTM groups (P=0.264) however waiting time for surgery was higher in the last one. Surgical complications in 30% (N=14) of operated patients (urethral fistula in 4 patients who underwent phalloplasty).
Conclusions:: It was found that 55.3% of patients pretended sex reassignment therapy from FTM. Most of the patients (74.1%) performed hormonal therapy without significant complications, so we can conclude that testosterone and estradiol treatment in physiological levels are effective and safe in female and male transsexual patients. Although 30% of operated patients had post-surgical complications, we consider that with increased clinical and surgical experience, long-term outcomes for transsexual persons should improve.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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