Effects of gender affirming hormone therapy on body mass index in transgender individuals: A longitudinal cohort study

Suppakitjanusant, Pichatorn; Ji, Yuhan; Stevenson, Mary O.; Chantrapanichkul, Panicha; Sineath, R. Craig; Goodman, Michael; Alvarez, Jessica A.; Tangpricha, Vin

doi:10.1016/j.jcte.2020.100230

Cited by 20 publications

(21 citation statements)

References 60 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Regardless, the captured adipose nuclei express the androgen receptor as expected and are thus of interest, especially considering the documented impact of androgens on energy metabolism and the fact that transgender men experience weight loss and redistribution of body fat (Fig. S2E, S12B) 13,[75][76][77][78] .…”

Section: Androgen Treatment Elicits Lipid Reduction Through Epithelia...mentioning

confidence: 69%

The molecular consequences of androgen activity in the human breast

Karimzadeh

Ing

et al. 2022

Preprint

View full text Add to dashboard Cite

SummaryThe mammary gland has been extensively studied for estrogen and progesterone reactivity, but the molecular effects of androgen in the breast remain largely unexplored. Transgender men are recorded female at birth but identify as male and may undergo gender-affirming androgen therapy to align their physical characteristics and gender identity. Here we perform single cell resolution transcriptome, chromatin, and spatial profiling of androgen treated breasts from transgender men. We find male-biased androgen receptor gene targets are upregulated in cells expressing androgen receptor, and that paracrine signaling drives sex-relevant changes in other cell types. We observe an altered epithelium, shifts in immune populations, and a reduction of capillary vasculature. Finally, we find evidence of the metabolic impact of androgen and identify a gene regulatory network driving androgen-directed fat loss. This work elucidates the molecular consequences of androgen in the human breast at single cell resolution.

show abstract

Section: Androgen Treatment Elicits Lipid Reduction Through Epithelia...mentioning

confidence: 69%

The molecular consequences of androgen activity in the human breast

Karimzadeh

Ing

et al. 2022

Preprint

View full text Add to dashboard Cite

show abstract

“…Building upon evidence that estrogen replacement therapy in transgender females is protective against metabolic syndrome [ 12 , 13 ], we aimed to investigate whether central estrogen supplementation in males would influence metabolic syndrome phenotypes. To evaluate this, obese male mice were instrumented with ICV cannulas and received daily 6-day administration [ 24 , 28 ] of low-dose central 17-β-estradiol administration ( Figure 1 ).…”

Section: Resultsmentioning

confidence: 99%

“…However, these methods oversimplify the role of sex hormones in metabolic homeostasis as they often investigate the dominant sex hormone with little evaluation of alternate sex hormone signaling (e.g., either testosterone in women or estrogen in men). Interestingly, transgender individuals receiving feminizing gender affirming therapy (i.e., estrogen) appear to be relatively protected from metabolic syndrome conditions, including type II diabetes, insulin resistance, and cardiovascular dysfunction [ 12 , 13 ]. However, global estrogen replacement poses numerous hurdles.…”

Section: Introductionmentioning

confidence: 99%

Central Feminization of Obese Male Mice Reduces Metabolic Syndrome

Blackmore

Young

2022

Brain Sciences

View full text Add to dashboard Cite

Metabolic syndrome encompasses a spectrum of conditions that increases the risk for cardiovascular and metabolic diseases. It is widely accepted that the sex hormone estrogen plays a protective metabolic role in premenopausal women, in part through central nervous system (CNS) mechanisms. However, most work to date has focused on the loss of estrogen in females (e.g., menopause). Interestingly, transgender individuals receiving feminizing gender affirming therapy (i.e., estrogen) are relatively protected from metabolic syndrome conditions, pointing to a role for CNS estrogen in the development of metabolic syndrome in men. Here, we show that estrogen signaling in the brain protects males from metabolic syndrome and obesity related complications. First, short-term CNS specific supplementation of low-dose 17-β-estradiol in diet-induced obese male mice resulted in a significant reduction in body weight in parallel with a decrease in food intake without alterations in energy expenditure. In conjunction, central supplementation of estrogen reduced visceral adiposity, including epididymal and abdominal regions, with slighter decreases in subcutaneous inguinal and thermogenic brown adipose tissue. Furthermore, central estrogen administration reduced the liver manifestation of metabolic syndrome including hepatomegaly and hepatic steatosis. Collectively, these findings indicate that a lack of estrogen action in the brain may predispose males to metabolic syndrome pathogenesis.

show abstract

“…The patients in this study with elevated BMI did not have surgery. Multiple cohort studies of trans adolescents and adults demonstrate a high prevalence of increased BMI overall [52][53][54] . A 2017 NIH analysis of Behavioral Risk Factors Surveillance System data showed that 72.4% of the trans adult respondents have a BMI equal to or greater than 25 kg/m 2 , compared to 65.5% of cisgender respondents [21] .…”

Section: Published Literature Does Not Provide Robust Evidence For Fa...mentioning

confidence: 99%

Weight stigma mitigating approaches to gender-affirming genital surgery

Castle¹,

Blasdel²,

Shakir³

et al. 2022

Plast Aesthet Res

View full text Add to dashboard Cite

The use of body mass index (BMI) to determine eligibility for gender-affirming surgery in transgender and nonbinary individuals has been contested. While BMI thresholds are often meant to be protective, restricting patients from access to surgery can also cause harm. There is a rationale for the continued use of BMI, but the inherent problems with it must also be recognized, including how weight stigma impacts patients’ access to gender-affirming surgery and influences clinical care. This article uses a narrative review of current literature to discuss how high BMI affects surgical outcomes in gender-affirming genital surgeries, as well as analogous procedures, existing de facto BMI thresholds, and how to both minimize the harms of proceeding with surgery in patients with a high BMI or the harms of delaying for weight loss. BMI factors into surgical decision-making based on the existing literature, which demonstrates that high BMI is associated with increased surgical risk, including higher incidences of surgical site infections and poor wound healing, as well as the possibility of free flap complications, which are a component of certain genital procedures. This patient population is at higher risk for eating disorders, and it is prudent to find alternatives to requiring patient self-monitored weight management. The impacts of weight stigma should be considered when treating gender-affirming surgery patients, and further data and research are needed to augment shared decision-making and lead to practice change.

show abstract

Effects of gender affirming hormone therapy on body mass index in transgender individuals: A longitudinal cohort study

Cited by 20 publications

References 60 publications

The molecular consequences of androgen activity in the human breast

The molecular consequences of androgen activity in the human breast

Central Feminization of Obese Male Mice Reduces Metabolic Syndrome

Weight stigma mitigating approaches to gender-affirming genital surgery

Contact Info

Product

Resources

About