Endocrine Abstracts

Gender Dysphoria (GD) is defined as incongruence between gender identity and physical phenotype. This condition exists in different psychological typologies: male-to-female (MtF) and female-to-male (FtM) transsexualism. In most cases the first manifestations can occur even during childhood. The transition project is a long and difficult path that involves a multidisciplinary team including endocrinologists, psychologist and plastic surgeons. Our study aims to describe socio-demographic characteristics in a population of transsexuals referred to Endocrinology Dept. in Catania during the last 15 years. A total of 117 patients were enrolled at the Garibaldi-Nesima Andrology Clinic in Catania from 2003 to 2018. During the years and especially during the last 5 years the number of patients who required hormone conversion therapy (HCT) has been increasing both between MtFs and FtMs. Patients who have come to our observation in recent years have started HCT earlier than patients who came to our Center in the early 2000s. The average age of FtM patients at the first observation is 27.7 years (SD 9.9 years), among them 3 minors (including the youngest of 14.2 years) and 4 over 40. Among our MtFs, the vast majority live in a situation of social hardship with weak family support. Among FtMs after HCT the final phenotype is significantly adherent to the virile image desired by these patients, although among the MtFs this is sometimes not entirely satisfactory. The surgical conversion of MtFs was performed preferably in centers in northern Italy and abroad, the interventions performed by FtMs mainly concern mastectomy and hysterectomy with ovariectomy performed in Sicilian centers. In our City there is still no reception center for transsexual people. Over the years, especially for the ‘word of mouth’ the number of subjects has increased, even though the drop-out level remains high, especially among the MtFs. Like has been observed elsewhere, at our center the MtFs are more represented than the FtMs. It has been observed also a younger patients’ age asking for the first endocrine consultation. In conclusion even if the overall prevalence of transsexualism reported in the literature is increasing, it is still very low and is mainly based on individuals attending clinical services and so does not provide an overall picture of prevalence in the general population.