Gender-affirming hormone therapy, mental health, and surgical considerations for aging transgender and gender diverse adults

Iwamoto, Sean J.; Defreyne, Justine; Kaoutzanis, Christodoulos; Davies, Robert D. M.; Moreau, Kerrie L.; Rothman, Micol S.

doi:10.1177/20420188231166494

Cited by 3 publications

(1 citation statement)

References 149 publications

(205 reference statements)

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“…Moreover, depending on the age the patient decides to begin their transition, HRT can begin anywhere from under 18 years to over 50 years old. While there is no consensus on the role age plays, it is an important factor to consider that has the potential to influence a patient’s response to HRT 16,17 .…”

Section: Introductionmentioning

confidence: 99%

Scientific Evidence of Prostate Cancer Progression Outcomes in Transgender Females after Hormone Replacement Therapy-Scoping Review Protocol

McAllister,

Panteah,

Nelson

et al. 2024

Preprint

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Transgender females undergoing hormone replacement therapy (HRT) as a component of the gender affirmation treatment (GAT) commonly retain their prostate, rendering them susceptible to developing prostate cancer (PC). Currently, patients with localized PC receive endocrine therapy (e.g., androgen ablation/castration). Once metastatic, patients undergo standard chemotherapy and/or novel treatment. Unfortunately, many fail to respond completely and develop untreatable, drug-resistant tumors consistent with reprogramming of crucial cell signal transduction pathways that promote tumor growth, invasiveness, and survival. There is no consensus among scientists or physicians on how HRT affects PC treatment options or its related signaling pathways, putting patients at risk for delayed diagnosis. This scoping review aims to analyze and collate the current scientific literature on PC progression in transgender females who have undergone HRT and how PC-initiated oncogenic pathways are impacted by HRT. The review's findings can potentially inform transgender healthcare and research. This scoping review will follow the Population-Concept-Context methodology for Joanna Briggs Institution Scoping Reviews. Relevant peer-reviewed studies will be identified from the following electronic databases: MEDLINE (PubMed), Embase (Elsevier), CINAHL (EBSCO), and Scopus (Elsevier). Sources of unpublished studies/ grey literature to be searched include bioRxiv (Cold Spring Harbor Laboratory), medRxiv (Cold Spring Harbor Laboratory), and MedNar (Deep Web Technologies). The search strings using keywords such as gender-affirmation treatment, transgender females, and prostate cancer will be conducted using Boolean logic. There will be no limitation on language or date of publication.

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Section: Introductionmentioning

confidence: 99%

Scientific Evidence of Prostate Cancer Progression Outcomes in Transgender Females after Hormone Replacement Therapy-Scoping Review Protocol

McAllister,

Panteah,

Nelson

et al. 2024

Preprint

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Getting old in the desired gender: a systematic review on aging diseases in transgender people

Ceolin,

Papa,

Scala

et al. 2024

J Endocrinol Invest

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Introduction The growing demographic presence of the transgender (TGD) population has sparked an increase in clinical investigations focusing on the impacts of gender-affirming hormone therapy (GAHT) in adults with gender dysphoria. Despite this surge in studies, there remains a significant gap in the literature regarding the health status of older TGD individuals. This review aims to assess prevalent pathological conditions within the TGD population, specifically concentrating on aging-related diseases investigated to date. Methods A systematic search across Embase Ovid, Scopus, PubMed, Cochrane Library, and Web of Science databases was conducted to identify articles reporting on the aging process in TGD individuals. Methodological quality was evaluated using Newcastle–Ottawa Scale (NOS) scores. Results Initial database searches yielded 12,688 studies, which were refined to 18 through elimination of duplicates and title/abstract review. Following a comprehensive appraisal, nine studies were included in the systematic review. These articles, published between 2017 and 2023, involved a total of 5403 participants. The evidence indicates a noteworthy percentage of the TGD population being at risk for cardiovascular diseases, experiencing depression or disability, and demonstrating hesitancy toward major recommended screening programs. Conclusions Limited studies on older TGD individuals highlight not only an organic risk of chronic diseases but also a cognitive/psychiatric risk that should not be underestimated. Further research is imperative to deepen our understanding of the pathophysiological mechanisms involved in the health challenges faced by older TGD individuals.

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Breast and cervical cancer in transgender men: literature review and a case report

Di Lisa,

Villa,

Filomeno

et al. 2024

Ther Adv Med Oncol

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Transgender individuals exhibit a higher prevalence of cancer-related risk factors, such as substance abuse and sexually transmitted infections. These factors, coupled with suboptimal adherence to cancer screening recommendations, may lead to a higher incidence of cancers, such as breast and cervical cancer, and contribute to delayed diagnoses in transgender patients. Herein, we report a unique case of a transgender man with a history of alcohol and drug abuse, undergoing gender-affirming exogenous testosterone therapy, who developed synchronous locally advanced breast cancer and human papilloma virus (HPV)-related cervical cancer. He underwent concurrent chemoradiation for cervical cancer and surgery followed by endocrine therapy for breast cancer. The treatments were suboptimals due to patient’s comorbidities, among them liver cirrhosis leading to an early death. Additionally, we have conducted a review of existing literature, including case reports, clinical studies, and review articles investigating the role of potential risk factors specifically related to breast and cervical tumors in transgender men. Gender-affirming testosterone therapy is common among transgender men to induce gender affirmation, but its link to breast cancer risk remains ambiguous, with studies being limited and sometimes contradictory. Conversely, HPV is a well-established cause of up to 99% of cervical cancers. Despite persistent risk for cervical cancer in transgender men who retain their cervix, several studies indicate notable disparities in screening adherence, due to personal and structural barriers. Moreover, alcohol and drug use disorders, commonly encountered in transgender population, may negatively influence the adherence to screening programs. Current cancer screening guidelines for this population are somewhat unclear, and specific programs based on more robust data are urgently required along with further tailored studies.

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Gender-affirming hormone therapy, mental health, and surgical considerations for aging transgender and gender diverse adults

Cited by 3 publications

References 149 publications

Scientific Evidence of Prostate Cancer Progression Outcomes in Transgender Females after Hormone Replacement Therapy-Scoping Review Protocol

Scientific Evidence of Prostate Cancer Progression Outcomes in Transgender Females after Hormone Replacement Therapy-Scoping Review Protocol

Getting old in the desired gender: a systematic review on aging diseases in transgender people

Breast and cervical cancer in transgender men: literature review and a case report

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