Endocrine Abstracts

Introduction: The prevalence of Transgender individuals seeking gender affirming hormone therapy (GAHT) has been increasing. It is important to closely monitor this therapy in order to minimize the risk of adverse effects.

Aim: To evaluate the safety and monitoring of the GAHT in the Portuguese adult transgender population

Methods: Cross-sectional study conducted in March 2021. Data collected through an online questionnaire that was delivered to adult transgender people living in Portugal who had been under GAHT for at least one year. To answer some of the items on the questionnaire, an ordinal scale ranging from 0 (worst result) to 6 (best result) was used.

Results: A total of 142 individuals answered the questionnaire: 101 under masculinizing GAHT (Group M) and 41 under feminizing GAHT (Group F), with a median age of 25.0(21.0–33.0) years. 43.3% of the individuals denied having signed an informed consent document and 11.3% denied having done blood sample analysis before starting GAHT. This happened more frequently with individuals of the Group F (24.4% vs 5.9%, P=0.002). Accordingly, this group also reported having obtained the first prescription of GAHT by an endocrinologist less frequently (58.5% vs 79.2%, P=0.012). 93.7% of the individuals had regular medical appointments because of the GAHT, although this was less common in Group F (85.4% vs 97.0%, P=0.010). 79.6% reported undergoing regular blood sample analysis to monitor the GAHT. Of those, 75.2% did so according to the timings recommend by WPATH. As for adverse effects, 89.7% of the individuals on Group M experienced at least one – more commonly mood swings (56,3%) and acne (52,9%) – and 96.3% of the individuals on Group F experienced at least one – more commonly decreased libido (66.7%) and mood swings (63.0%). The perceived overall safety of the GHAT was classified with a median of 5.0(4.0-6.0) points, although individuals on the Group F scored significantly lower (4.3 vs 5.0 points, P=0.007).

Discussion: This study highlights the importance of the involvement of specialized physicians, namely endocrinologists, in the prescription and monitoring of the GAHT. There is still plenty of room to improve Transgender health care in Portugal, mostly in transgender people undergoing feminizing GHAT - a population known to be especially vulnerable to social stigma.