Endocrine Abstracts

Androgen therapy is the mainstay of treatment in female to male (FtM) transgender persons to increase testosterone levels, suppress oestrogens and treat gender dysphoria. Testosterone is widely used for male hypogonadism, but is comparatively under-investigated in FtM transgender persons. The aim of our study was to identify treatment and safety outcomes associated with testosterone use in transgender medicine. A literature search was conducted in PubMed/Medline, as well as EMBASE, using MeSH terms. A total of 260 records were identified. Forty-eight studies were suitable for final analysis. Androgens in FtM transgender people are effective to lower voice frequency, increase facial hair-growth, and increase hematocrit and hemoglobin levels to adult male reference ranges. Similarly, body uneasiness and sexual desire have been shown to improve after androgen use. A 1.2-fold to 3.7-fold higher rate of myocardial infarction has been reported retrospectively compared to cisgender women. Blood pressure, glycaemic control and body mass index remained unchanged in FtM transgender people. However, total cholesterol levels may increase above recommended targets following testosterone treatment. Androgens in FtM transgender persons have positive physical effects, but it is important to highlight cardio-metabolic risk factors. Studies on mortality require prospective evaluation with longer participant follow-up periods. Randomised control trials, longer follow-up periods and studies involving older participants may further improve the management FtM transgender people.