Gender affirming hormonal treatment in Danish transgender persons: A nationwide register‐based study

Abstract

Background: Gender affirming hormonal treatment (GAHT) is a cornerstone in transgender care. National data are sparse regarding use of hormonal treatment by transgender persons. Aim: To assess use of GAHT in transgender persons. Design: National register-based cohort study in Danish transgender persons followed from 2000 until 2018. The main outcome measure was prescription and purchase of GAHT. Persons with ICD-10 diagnosis code of "gender identity disorder" (CGI-cohort) and persons with legal sex change but without diagnosis (CPR-cohort) were included. In the CGI-cohort, transgender women were defined by prescription of estrogen and/or cyproterone acetate and/or testosterone-5-alpha reductase inhibitors, and transgender men were defined by prescription of testosterone after study inclusion. Discontinuation of GAHT was defined as no purchase of GAHT ≥13 months or shift from feminizing to masculinizing hormone treatment, or vice versa. Results: The cohort included 2789 transgender persons (n = 1717, CGI-cohort and n = 1072, CPR-cohort). The median age (interquartile range) at study inclusion was 26.1 (17.7) years for persons assigned male at birth (n = 1447) and 22.5 (10.5) years for persons assigned female at birth (n = 1342). In the CGI-cohort, the event rate for GAHT in transgender women increased from 4.0 (95% confidence interval [CI]: [3.1; 5.2]) events per 100 person in

A systematic review of psychosocial functioning changes after gender-affirming hormone therapy among transgender people

“…Transgender people tend to engage with these therapies to modify their physical presentation in line with their gender identity 6,7 ; importantly, sex hormones may also affect psychological states and social interactions, as is observed during puberty 8 . However, despite the large and growing prevalence of gender-affirming hormone therapy across countries 9 , no systematic review of research has been conducted to examine the state and quality of evidence for effects of gender-affirming hormone therapy on psychosocial functioning among transgender people. Research in humans and non-human animals has suggested that hormones may influence psychosocial functioning via biological pathways [10][11][12][13] , but findings in this literature have often been mixed or inconclusive.…”