The Development of Sex Reassignment Surgery in Thailand: A Social Perspective

Chokrungvaranont, Prayuth; Selvaggi, Gennaro; Jindarak, Sirachai; Angspatt, Apichai; Pungrasmi, Pornthep; Suwajo, Poonpismai; Tiewtranon, Preecha

doi:10.1155/2014/182981

Cited by 26 publications

(11 citation statements)

References 11 publications

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“…This usually involves the use of an estrogen and anti‐androgen concomitantly. In a cross‐sectional sample of TGW in Thailand, approximately 75% reported using FHT for a mean duration of 10 years . Many TGW used higher‐than‐recommended doses and 50% reported symptoms from these higher doses of oral contraceptive pills .…”

Section: Introductionmentioning

confidence: 99%

Drug‐drug interactions between feminizing hormone therapy and pre‐exposure prophylaxis among transgender women: the iFACT study

et al. 2019

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Introduction Concerns over potential drug‐drug interactions (DDI) between feminizing hormone therapy (FHT) and pre‐exposure prophylaxis (PrEP) have hampered uptake and adherence of PrEP among transgender women (TGW). To determine DDI between FHT and PrEP, we measured the pharmacokinetic (PK) parameters of blood plasma estradiol (E2) and tenofovir (TFV) in Thai TGW. Methods Twenty TGW who never underwent orchiectomy and had not received injectable FHT within six months were enrolled between January and March 2018. FHT (E2 valerate and cyproterone acetate) were prescribed to participants at baseline until week 5, and then from week 8 until the end of study. Daily PrEP (tenofovir disoproxil fumarate/emtricitabine) was initiated at week 3 and continued without interruption. Intensive E2 PK parameters and testosterone concentration at 24 hours (C24) were measured at weeks 3 (without PrEP) and 5 (with PrEP), and intensive TFV PK parameters were measured at weeks 5 (with FHT) and 8 (without FHT). Results Median (interquartile range) age, body mass index, and creatinine clearance were 21.5 (21–26) years, 20.6 (19.0‐22.4) kg/m2, and 116 (101‐126.5) mL/min, respectively. The geometric mean (%CV) of area under curve from time zero to 24 hours (AUC0‐24), maximum concentration (Cmax), and C24 of E2 at weeks 3 and 5 were 775.13 (26.2) pg h/mL, 51.47 (26.9) pg/mL, and 15.15 (42.0) pg/mL; and 782.84 (39.6), 55.76 (32.9), and 14.32 (67.4), respectively. The geometric mean (%CV) of TFV AUC0‐24, Cmax, and C24 at weeks 5 and 8 were 2242.1 (26.5) ng h/mL, 353.9 (34.0) ng/mL, and 40.9 (31.4) ng/mL; and 2530.2 (31.3), 311.4 (30.0), and 49.8 (29.6), respectively. The geometric mean of TFV AUC0‐24 and C24 at week 5 were significantly less than that at week 8 by 12% (p = 0.03) and 18% (p < 0.001), respectively. There were no significant changes in E2 PK parameters and median C24 of bioavailable testosterone between week 3 and week 5. Conclusions Our study demonstrated lower blood plasma TFV exposure in the presence of FHT, suggesting that FHT may potentially affect PrEP efficacy among TGW; but E2 exposure was not affected by PrEP. Further studies are warranted to determine whether these reductions in TFV are clinically significant. Clinical Trial Number: NCT03620734.

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Section: Introductionmentioning

confidence: 99%

Drug‐drug interactions between feminizing hormone therapy and pre‐exposure prophylaxis among transgender women: the iFACT study

et al. 2019

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“…For the best possible care, information regarding irreversible physical changes should be provided before the initiation of treatment [ 1 ]. Studies have shown that almost all Thai transsexuals self-medicate with hormonal therapy that includes hormones that are usually bought directly from the pharmacy without any prescription; therefore, transwomen are not warned about the loss of reproductive function [ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

Spermatogenesis Abnormalities following Hormonal Therapy in Transwomen

Jindarak

Nilprapha

Atikankul

et al. 2018

BioMed Research International

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Objective To measure spermatogenesis abnormalities in transwomen at the time of sex reassignment surgery (SRS) and to analyze the association between hormonal therapy duration and infertility severity. Design Retrospective study. Setting University hospital. Patients One-hundred seventy-three transwomen who underwent SRS from January 2000 to December 2015. Interventions All orchidectomy specimens were retrospectively reviewed and classified. History of hormonal therapy duration was retrieved from medical records. Main Outcome Measures Histological examinations of orchidectomy specimens were performed to assess spermatogenesis. Results One-hundred seventy-three orchidectomy specimens were evaluated. Histological examinations showed maturation arrest in 36.4%, hypospermatogenesis in 26%, Sertoli cell-only syndrome in 20.2%, normal spermatogenesis in 11%, and seminiferous tubule hyalinization in 6.4% of the specimens. Spermatogenesis abnormality severity was not associated with the total therapy duration (P = 0.81) or patient age at the time of surgery (P = 0.88). Testicular volumes and sizes were associated with spermatogenesis abnormality severity (P = 0.001 and P = 0.026, right testicle and left testicle, resp.). Conclusion(s) Feminizing hormonal treatment leads to reductions in testicular germ cell levels. All transwomen should be warned about this consequence, and gamete preservation should be offered before starting hormonal treatment.

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“…Transgender men and women are unable to enter a heterosexual marriage under existing marriage legislation or to have related rights and benefits. Transgender people, including those who have undergone gender-affirming surgery, also cannot legally change their personal title or legal sex on state documents (Chokrungvaranont et al 2014). Intersex individuals may change their legal sex after gender affirming surgery, provided they have documentation from a health care provider certifying their original legal sex had been incorrectly assigned (iLaw 2012).…”

Section: Resultsmentioning

confidence: 99%

Economic Inclusion of LGBTI Groups in Thailand

2018

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This work is a product of the staff of The World Bank with external contributions. The findings, interpretations, and conclusions expressed in this work do not necessarily reflect the views of The World Bank, its Board of Executive Directors, or the governments they represent. The World Bank does not guarantee the accuracy of the data included in this work. The boundaries, colors, denominations, and other information shown on any map in this work do not imply any judgment on the part of The World Bank concerning the legal status of any territory or the endorsement or acceptance of such boundaries.

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The Development of Sex Reassignment Surgery in Thailand: A Social Perspective

Cited by 26 publications

References 11 publications

Drug‐drug interactions between feminizing hormone therapy and pre‐exposure prophylaxis among transgender women: the iFACT study

Drug‐drug interactions between feminizing hormone therapy and pre‐exposure prophylaxis among transgender women: the iFACT study

Spermatogenesis Abnormalities following Hormonal Therapy in Transwomen

Economic Inclusion of LGBTI Groups in Thailand

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