ECE2023 Poster Presentations Reproductive and Developmental Endocrinology (108 abstracts)
Effects of gender affirming treatments on sex hormone levels, mental well being and body image quality of life in transgender individuals
Nubar Rasulova 1 , Esin Karakiliç Özturan 2 , Hulya Hacisahinogullari 1 , Gulsah Yenidunya Yalin 1 , Neşe Direk Tecirli 3 , Ozlem Soyluk Selcukbiricik 1 , Nurdan Gul 1 , Ayse Kubat Uzum 1 & Feyza Darendeliler 2
1Istanbul University Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Turkey; 2Istanbul University Faculty of Medicine, Department of Paediatrics, Division of Paediatrics Endocrinology, Turkey; 3Istanbul University Faculty of Medicine, Department of Mental Health and Diseases, Turkey
Objective: Transgender individuals endure gender dysphoria and incongruence between physical appearance and gender identity. We aimed to investigate effects of gender affirming treatments on sex hormone levels, mental well being and body image quality of life in these individuals.
Material and Method: This is a descriptive cross sectional study. Transgender individuals who were transitioned from pediatric to adult care (n: 12) and who were formerly followed up in endocrinology department for at least six months (n:25) were included. Groups consisted of female to male (FTM, n: 19) and male to female (MTF, n:18) transgender individuals. Treatments were classified as gender-affirming hormone therapy [GAHT: GnRH analog (GnRHa) and/or cross sex hormone treatment (CHT)] and gender affirming surgery (GAS). Participants were invited to complete Patient Health Questionnaire (PHQ-9) and Body Image Quality of Life Inventory (BIQLI). Sex hormone levels, onset of virilization or feminization symptoms, patient outcome questionnaire scores were compared.
Results: Demographic and clinical characteristics are demostrated in Table-1. PHQ-9 scores were correlated with age (P=0,03, r:-0,56), BIQLI score (P=0,006, r:-0,674), onset of treatment benefit (P=0,03, r: 0,58) and BIQLI scores were correlated with age (P=0,02, r:0,57) and presence of GAS (P=0,006, r:0,67) among transmale individuals. In Transfemale individuals BIQLI scores were correlated with age (P=0,008, r:0,601), PHQ scores (P=0,002, r:-0,936), testosterone levels on 6th and 12th months (P=0,02, r:-0,93 and P=0,02, r:-0,93, respectively).
| Transfemale | Transmale | |||||
| GnRH Analog + CSH Treatment (n:5) | CSH Treatment (n:13) | p | GnRH Analog + CSH Treatment (n:7) | CSH Treatment (n:12) | p | |
| Age (year) | 21,6±3,5 | 26,6±6,0 | 0,1 | 19,1±1,46 | 27,2±4,73 | 0,001 |
| BKI (kg/m2) | 22,2±3,8 | 25,1±6,2 | 0,6 | 25,0±4,7 | 25,1±7,01 | 0,65 |
| Smoking | ||||||
| Present | n:1 | n:7 | 0,3 | n:5 | n:9 | 0,8 |
| Absent | n:4 | n:6 | n:2 | n:3 | ||
| Gender Affirming Surgery (GAS) | ||||||
| Surgery (GAS) | n:4 | n:7 | 0,3 | n:2 | n:9 | 0,04 |
| Present | n:1 | n:6 | n:5 | n:3 | ||
| Absent | ||||||
| Supression of erections/menstruation | 3,7±2,06 | 2,2±1,5 | 0,3 | 1,0±0,0 | 5,2±3,7 | 0,001 |
| Onset of Treatment Benefit (month) | 4,1±1,9 | 3,67±1,7 | 0,4 | 7,8±8,3 | 9,5±8,5 | 0,31 |
| Initial Testosterone (ng/ml) | 6,3±2,1 | 5,4±2,9 | 0,83 | 0,4±0,18 | 0,6±0,32 | 0,24 |
| Initial Estradiol (pg/ml) | 28,9±10,2 | 44,8±28,4 | 0,4 | 99±40,7 | 88,4±59,2 | 0,50 |
| Testosterone change in 6th/12th month (ng/ml) | -5,8±2,1 -5,9±2,2 | -2,3±2,1 -3,4±-1,6 | 0,01 0,02 | 1,77±0,51 2,3±0,89 | 3,49±1,93 6,2±2,36 | 0,018 0,010 |
| Estradiol change 6th/12th month (pg/ml) | 22,0±39,1 46,1±29,1 | 26,6±45,3 20,7±33,8 | 0,9 0,1 | -30,2±19,2 -15,2±12,9 | -63,3±40,5 -70,1±59,7 | 0,034 0,027 |
| PHQ-9 score | 2±1,4 | 6,5±10,0 | 0,64 | 9,8±8,3 | 4,4±4,1 | 0,14 |
| BIQLI score | 45±1,4 | 30,0+25,9 | 0,85 | 16,3±31,3 | 43±7,4 | 0,033 |
Conclusion: Apart from GAHT, age and presence of GAS are prominent factors effecting body image quality of life and PHQ-9 scores in transgender individuals.
Keywords: gender dysphoria, gender affirmation treatment, body image quality of life
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