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SUN-051 Gender Dysphoria - Data from One Hundred Patients

Introduction: Gender dysphoria (GD) is a disease in which the patient's gender identity does not correspond to their biological gender. Traditionally, sex is assigned accordingly to the sexual organs as male or female, however these patients do not identify with this classification. A biologica...

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Autores principales: Ferreira, Maria João, Castedo, José Luis, Pedro, Jorge Pires, Salazar, Cristina Daniela, Costa, Cláudia Fernandes, Carvalho, Davide M
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2020
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Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7208482/
http://dx.doi.org/10.1210/jendso/bvaa046.931
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author Ferreira, Maria João
Castedo, José Luis
Pedro, Jorge Pires
Salazar, Cristina Daniela
Costa, Cláudia Fernandes
Carvalho, Davide M
author_facet Ferreira, Maria João
Castedo, José Luis
Pedro, Jorge Pires
Salazar, Cristina Daniela
Costa, Cláudia Fernandes
Carvalho, Davide M
author_sort Ferreira, Maria João
collection PubMed
description Introduction: Gender dysphoria (GD) is a disease in which the patient's gender identity does not correspond to their biological gender. Traditionally, sex is assigned accordingly to the sexual organs as male or female, however these patients do not identify with this classification. A biological male who identifies himself as a female is referred to as transgender female or male to female GD (MtF) and a biological female who identifies herself as a male is referred to as a transgender male or female to male GD (FtM). In our center there is a multidisciplinary consultation to approach and follow up patients with GD. Our work is an analysis of the patients who are currently attending this consultation. Methods: Retrospective study of patients attending the Sexual Medicine Group Consultation with diagnosis of GD. Results: 100 patients diagnosed with GD, of which 65% had GD FtM and 35% MtF. The median age is 25 years (± 9.5 years). Regarding the onset of symptoms, 76% of patients report that it occurred in childhood (before age 10); 20% from 10 to 18 years old and only 4% reported having occurred after 18 years. The median age for starting treatment is at 22 years (± 7.5 years). About 83% of the patients start therapy on medical advice, the remaining are self-medicated; 86% of FtM GD patients are currently on testosterone therapy; 85% of MtF GD patients are on estrogen therapy and 71% on anti-androgens. Concerning co-morbidities: 22% of patients have depression; 39% smoke; 6% are HIV-infected; 4% dyslipidemia and 2% hypertension. 47 (47%) patients underwent at least one surgical treatment; the average time to the first surgery was 2 years. Of the FtM GD patients, 23 (35%) patients underwent mastectomy, 10 (15%) hysterectomy and oophorectomy and 3 (5%) neophaloplasty; of the MtF GD patients 8 (23%) underwent augmentation mammoplasty; 7 (20%) neovaginoplasty. Two patients had a family history of GD. One case of Klinefelter’s syndrome and one case of congenital adrenal hyperplasia was diagnosed during the study prior to therapy initiation. Discussion: There was a higher prevalence of FtM compared to MtF, unlike most centers reporting a higher prevalence of MtF. Regarding the proportion of patients on medical therapy, the data are in line with data from other centers already published, as well as the fact that most patients in our study are young. Conclusion: The demand for medical help from GD patients is increasing. The evaluation of these patients by endocrinology before and throughout treatment is essential, not only for the evaluation of contraindications or side effects of therapy, but also for the identification of endocrinological diseases. This is the first work, to our knowledge, to portray the case series of a consultation center dedicated to the treatment of patients with GD in Portugal.
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spelling pubmed-72084822020-05-13 SUN-051 Gender Dysphoria - Data from One Hundred Patients Ferreira, Maria João Castedo, José Luis Pedro, Jorge Pires Salazar, Cristina Daniela Costa, Cláudia Fernandes Carvalho, Davide M J Endocr Soc Reproductive Endocrinology Introduction: Gender dysphoria (GD) is a disease in which the patient's gender identity does not correspond to their biological gender. Traditionally, sex is assigned accordingly to the sexual organs as male or female, however these patients do not identify with this classification. A biological male who identifies himself as a female is referred to as transgender female or male to female GD (MtF) and a biological female who identifies herself as a male is referred to as a transgender male or female to male GD (FtM). In our center there is a multidisciplinary consultation to approach and follow up patients with GD. Our work is an analysis of the patients who are currently attending this consultation. Methods: Retrospective study of patients attending the Sexual Medicine Group Consultation with diagnosis of GD. Results: 100 patients diagnosed with GD, of which 65% had GD FtM and 35% MtF. The median age is 25 years (± 9.5 years). Regarding the onset of symptoms, 76% of patients report that it occurred in childhood (before age 10); 20% from 10 to 18 years old and only 4% reported having occurred after 18 years. The median age for starting treatment is at 22 years (± 7.5 years). About 83% of the patients start therapy on medical advice, the remaining are self-medicated; 86% of FtM GD patients are currently on testosterone therapy; 85% of MtF GD patients are on estrogen therapy and 71% on anti-androgens. Concerning co-morbidities: 22% of patients have depression; 39% smoke; 6% are HIV-infected; 4% dyslipidemia and 2% hypertension. 47 (47%) patients underwent at least one surgical treatment; the average time to the first surgery was 2 years. Of the FtM GD patients, 23 (35%) patients underwent mastectomy, 10 (15%) hysterectomy and oophorectomy and 3 (5%) neophaloplasty; of the MtF GD patients 8 (23%) underwent augmentation mammoplasty; 7 (20%) neovaginoplasty. Two patients had a family history of GD. One case of Klinefelter’s syndrome and one case of congenital adrenal hyperplasia was diagnosed during the study prior to therapy initiation. Discussion: There was a higher prevalence of FtM compared to MtF, unlike most centers reporting a higher prevalence of MtF. Regarding the proportion of patients on medical therapy, the data are in line with data from other centers already published, as well as the fact that most patients in our study are young. Conclusion: The demand for medical help from GD patients is increasing. The evaluation of these patients by endocrinology before and throughout treatment is essential, not only for the evaluation of contraindications or side effects of therapy, but also for the identification of endocrinological diseases. This is the first work, to our knowledge, to portray the case series of a consultation center dedicated to the treatment of patients with GD in Portugal. Oxford University Press 2020-05-08 /pmc/articles/PMC7208482/ http://dx.doi.org/10.1210/jendso/bvaa046.931 Text en © Endocrine Society 2020. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Reproductive Endocrinology
Ferreira, Maria João
Castedo, José Luis
Pedro, Jorge Pires
Salazar, Cristina Daniela
Costa, Cláudia Fernandes
Carvalho, Davide M
SUN-051 Gender Dysphoria - Data from One Hundred Patients
title SUN-051 Gender Dysphoria - Data from One Hundred Patients
title_full SUN-051 Gender Dysphoria - Data from One Hundred Patients
title_fullStr SUN-051 Gender Dysphoria - Data from One Hundred Patients
title_full_unstemmed SUN-051 Gender Dysphoria - Data from One Hundred Patients
title_short SUN-051 Gender Dysphoria - Data from One Hundred Patients
title_sort sun-051 gender dysphoria - data from one hundred patients
topic Reproductive Endocrinology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7208482/
http://dx.doi.org/10.1210/jendso/bvaa046.931
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