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Guy Tsjoen - One of the best experts on this subject based on the ideXlab platform.
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long term evaluation of cross sex hormone treatment in Transsexual persons
The Journal of Sexual Medicine, 2012Co-Authors: Katrien Wierckx, Gunter Heylens, Eva Van Caenegem, Steven Weyers, Sven C Mueller, Greet Roef, Guy TsjoenAbstract:ABSTRACT Introduction Long‐term effects and side effects of cross‐sex hormone treatment in Transsexual persons are not well known. Aim The aim of this study is to describe the effects and side effects of cross‐sex hormone therapy in both Transsexual men and women. Main Outcome Measures Hormone levels were measured by immunoassays. Physical health was assessed by physical examination and questionnaires on general health and specific side effects, areal bone parameters by dual energy X‐ray absorptiometry. Methods Single center cross‐sectional study in 100 Transsexual persons post‐sex reassignment surgery and on average 10 years on cross‐sex hormone therapy. Results Transsexual men did not experience important side effects such as cardiovascular events, hormone‐related cancers, or osteoporosis. In contrast, a quarter of the Transsexual women had osteoporosis at the lumbar spine and radius. Moreover, 6% of Transsexual women experienced a thromboembolic event and another 6% experienced other cardiovascular problems after on average 11.3 hormone treatment years. None of the Transsexual women experienced a hormone‐related cancer during treatment. Conclusion Cross‐sex hormone treatment appears to be safe in Transsexual men. On the other hand, a substantial number of Transsexual women suffered from osteoporosis at the lumbar spine and distal arm. Twelve percent of Transsexual women experienced thromboembolic and/or other cardiovascular events during hormone treatment, possibly related to older age, estrogen treatment, and lifestyle factors. In order to decrease cardiovascular morbidity, more attention should be paid to decrease cardiovascular risk factors during hormone therapy management. Wierckx K, Mueller, S, Weyers S, Van Caenegem E, Roef G, Heylens G, and T'Sjoen G. Long‐term evaluation of cross‐sex hormone treatment in Transsexual persons. J Sex Med **;**:**–** .
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bone mass bone geometry and body composition in female to male Transsexual persons after long term cross sex hormonal therapy
The Journal of Clinical Endocrinology and Metabolism, 2012Co-Authors: E Van Caenegem, Katrien Wierckx, Youri Taes, David Dedecker, F Van De Peer, Kaatje Toye, Jeanmarc Kaufman, Guy TsjoenAbstract:Context Female-to-male Transsexual persons (Transsexual men) undergo extreme hormonal changes due to ovariectomy and testosterone substitution, allowing studies on sex steroid effects on bone geometry and physiology in the adult. Objective The objective of the study was to examine the effects of cross-gender sex steroid exposure on volumetric bone parameters in Transsexual men. Design This was a cross-sectional study. Setting Participants were recruited from the Center for Sexology and Gender Problems at the Ghent University Hospital (Ghent, Belgium). Participants Fifty Transsexual men after sex reassignment surgery with 50 age-matched control women and an additional 16 Transsexual men before testosterone substitution and sex reassignment surgery with 16 control women participated in the study. Main outcome measures The main outcome measures were areal and volumetric bone parameters using dual-energy X-ray absorptiometry and peripheral quantitative computed tomography, body composition (dual-energy X-ray absorptiometry), sex steroids, markers of bone turnover and grip strength. Results Before hormonal treatment, Transsexual men had similar body composition and bone geometry as female controls. The Transsexual men on long-term testosterone therapy, however, demonstrated a higher lean body mass and muscle mass and a greater grip strength as well as a lower body and subcutaneous fat mass and a larger waist and smaller hip circumference compared with female controls (all P Conclusions Transsexual men on testosterone substitution therapy present with a different body composition with more muscle mass and strength and less fat mass as well as an altered bone geometry with larger bones compared with female controls.
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long term assessment of the physical mental and sexual health among Transsexual women
The Journal of Sexual Medicine, 2009Co-Authors: Steven Weyers, Griet De Cuypere, Gunter Heylens, Els Elaut, Petra De Sutter, Jan Gerris, Guy Tsjoen, Hans VerstraelenAbstract:ABSTRACT Introduction Transsexualism is the most extreme form of gender identity disorder and most Transsexuals eventually pursue sex reassignment surgery (SRS). In Transsexual women, this comprises removal of the male reproductive organs, creation of a neovagina and clitoris, and often implantation of breast prostheses. Studies have shown good sexual satisfaction after transition. However, long-term follow-up data on physical, mental and sexual functioning are lacking. Aim To gather information on physical, mental, and sexual well-being, health-promoting behavior and satisfaction with gender-related body features of Transsexual women who had undergone SRS. Methods Fifty Transsexual women who had undergone SRS ≥6 months earlier were recruited. Main Outcome Measures Self-reported physical and mental health using the Dutch version of the Short-Form-36 (SF-36) Health Survey; sexual functioning using the Dutch version of the Female Sexual Function Index (FSFI). Satisfaction with gender-related bodily features as well as with perceived female appearance; importance of sex, relationship quality, necessity and advisability of gynecological exams, as well as health concerns and feelings of regret concerning transition were scored. Results Compared with reference populations, Transsexual women scored good on physical and mental level (SF-36). Gender-related bodily features were shown to be of high value. Appreciation of their appearance as perceived by others, as well as their own satisfaction with their self-image as women obtained a good score (8 and 9, respectively). However, sexual functioning as assessed through FSFI was suboptimal when compared with biological women, especially the sublevels concerning arousal, lubrication, and pain. Superior scores concerning sexual function were obtained in those Transsexual women who were in a relationship and in heterosexuals. Conclusions Transsexual women function well on a physical, emotional, psychological and social level. With respect to sexuality, they suffer from specific difficulties, especially concerning arousal, lubrication, and pain. Weyers S, Elaut E, De Sutter P, Gerris J, T'Sjoen G, Heylens G, De Cuypere G, and Verstraelen H. Long-term assessment of the physical, mental, and sexual health among Transsexual women. J Sex Med 2009;6:752–760.
L J G Gooren - One of the best experts on this subject based on the ideXlab platform.
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patho physiology of cross sex hormone administration to Transsexual people the potential impact of male female genetic differences
Andrologia, 2015Co-Authors: L J G Gooren, Baudewijntje P C Kreukels, Bruno Lapauw, Eric J GiltayAbstract:There is a limited body of knowledge of desired and undesired effects of cross-sex hormones in Transsexual people. Little attention has been given to the fact that chromosomal configurations, 46,XY in male-to-female Transsexuals subjects (MtoF) and 46,XX in female-to-male Transsexual subjects (FtoM), obviously, remain unchanged. These differences in their genomes cause sex differences in the functions of cells. This study reviews sex differences in metabolism/cardiovascular pathology, immune mechanisms, bone (patho)physiology and brain functions and examines whether they are, maybe partially, determined by genetic mechanisms rather than by (cross-sex) hormones. There do not appear to be major genetic impacts on the changes in bone physiology. Also immune functions are rather unaffected and the evidence for an increase of autoimmune disease in MtoF is preliminary. Brain functions of Transsexuals may have differed from controls before cross-sex hormones; they do undergo shifts upon cross-sex hormone treatment, but there is no evidence for changes in sex-specific brain disease. The prevalence of cardiovascular disease is higher in MtoF receiving oestrogens than in FtoM receiving androgens. While type of oestrogen and route of administration might be significant, it is reasonable to speculate that nonhormonal/genetic factors play a role.
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effects of sex steroids on components of the insulin resistance syndrome in Transsexual subjects
Clinical Endocrinology, 2003Co-Authors: Jolanda M H Elbers, H Asscheman, Erik J Giltay, Tom Teerlink, Peter G Scheffer, J C Seidell, L J G GoorenAbstract:objective Sex differences are found in most components of the insulin resistance syndrome and the associated cardiovascular risk profile. These differences are attributed to sex-specific sex steroid profiles, but the effects of sex steroids on the individual components of the insulin resistance syndrome remain incompletely understood. design Prospective, intervention study. subjects In 37 young (age range 16?36 years), nonobese [body mass index (BMI) <29], Transsexual subjects, effects of ethinyl oestradiol (100 µg/day) + cyproterone acetate (100 mg/day) administration were evaluated in 20 male-to-female Transsexuals and of testosterone-ester administration [250 mg intramuscularly (i.m.)/2 weeks] in 17 female-to-male Transsexuals. measurements We studied lipid spectrum, postheparin hepatic lipase (HL) and lipoprotein lipase (LPL) activity, blood pressure, glucose utilization (by euglycaemic hyperinsulinaemic clamp), and fat areas (by magnetic resonance imaging) at baseline and during 1-year cross-sex hormone administration. results Oestrogens + antiandrogens increased high-density lipoprotein (HDL)-cholesterol and decreased LDL-cholesterol, and HL activity, which are considered beneficial. But this combination also increased triglycerides, blood pressure, subcutaneous fat and visceral fat, and decreased the LDL-particle size, LPL activity and insulin sensitivity, which are all considered detrimental. Testosterone reduced HDL-cholesterol and the LDL-particle size, and increased triglycerides and HL activity. An android fat distribution was induced (i.e. decreased subcutaneous and increased visceral fat). Blood pressure, total and LDL-cholesterol, LPL activity and insulin sensitivity were mainly unaffected. conclusions The effects of cross-sex hormone treatment ? in the dosages used in this study ? in healthy, nonobese, young Transsexual subjects do not show unequivocally that female sex steroids, given in large amounts to male subjects, have beneficial effects on cardiovascular profile and that high dose testosterone administration to female subjects is detrimental with respect to cardiovascular risk.
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mortality and morbidity in Transsexual subjects treated with cross sex hormones
Clinical Endocrinology, 1997Co-Authors: P J M Van Kesteren, H Asscheman, J Megens, L J G GoorenAbstract:OBJECTIVE The optimum steroid hormone treatment regimes for Transsexual subjects has not yet been established. We have investigated the mortality and morbidity figures in a large group of Transsexual subjects receiving cross-sex hormone treatment. DESIGN A retrospective, descriptive study in a university teaching hospital. SUBJECTS Eight hundred and sixteen male-to-female (M → F) and 293 female-to-male (F → M) Transsexuals. INTERVENTIONS Subjects had been treated with cross-sex hormones for a total of 10 152 patient-years. OUTCOME MEASURES Standardized mortality and incidence ratios were calculated from the general Dutch population (age- and gender-adjusted) and were also compared to side effects of cross-sex hormones in Transsexuals reported in the literature. RESULTS In both the M → F and F → M Transsexuals, total mortality was not higher than in the general population and, largely, the observed mortality could not be related to hormone treatment. Venous thromboembolism was the major complication in M → F Transsexuals treated with oral oestrogens and anti-androgens, but fewer cases were observed since the introduction of transdermal oestradiol in the treatment of Transsexuals over 40 years of age. No cases of breast carcinoma but one case of prostatic carcinoma were encountered in our population. No serious morbidity was observed which could be related to androgen treatment in the F → M Transsexuals. CONCLUSION Mortality in male-to-female and female-to-male Transsexuals is not increased during cross-sex hormone treatment. Transdermal oestradiol administration is recommended in male-to-female Transsexuals, particularly in the population over 40 years in whom a high incidence of venous thromboembolism was observed with oral oestrogens. It seems that in view of the deep psychological needs of Transsexuals to undergo sex reassignment, our treatment schedule of cross-sex hormone administration is acceptably safe.
Katrien Wierckx - One of the best experts on this subject based on the ideXlab platform.
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long term evaluation of cross sex hormone treatment in Transsexual persons
The Journal of Sexual Medicine, 2012Co-Authors: Katrien Wierckx, Gunter Heylens, Eva Van Caenegem, Steven Weyers, Sven C Mueller, Greet Roef, Guy TsjoenAbstract:ABSTRACT Introduction Long‐term effects and side effects of cross‐sex hormone treatment in Transsexual persons are not well known. Aim The aim of this study is to describe the effects and side effects of cross‐sex hormone therapy in both Transsexual men and women. Main Outcome Measures Hormone levels were measured by immunoassays. Physical health was assessed by physical examination and questionnaires on general health and specific side effects, areal bone parameters by dual energy X‐ray absorptiometry. Methods Single center cross‐sectional study in 100 Transsexual persons post‐sex reassignment surgery and on average 10 years on cross‐sex hormone therapy. Results Transsexual men did not experience important side effects such as cardiovascular events, hormone‐related cancers, or osteoporosis. In contrast, a quarter of the Transsexual women had osteoporosis at the lumbar spine and radius. Moreover, 6% of Transsexual women experienced a thromboembolic event and another 6% experienced other cardiovascular problems after on average 11.3 hormone treatment years. None of the Transsexual women experienced a hormone‐related cancer during treatment. Conclusion Cross‐sex hormone treatment appears to be safe in Transsexual men. On the other hand, a substantial number of Transsexual women suffered from osteoporosis at the lumbar spine and distal arm. Twelve percent of Transsexual women experienced thromboembolic and/or other cardiovascular events during hormone treatment, possibly related to older age, estrogen treatment, and lifestyle factors. In order to decrease cardiovascular morbidity, more attention should be paid to decrease cardiovascular risk factors during hormone therapy management. Wierckx K, Mueller, S, Weyers S, Van Caenegem E, Roef G, Heylens G, and T'Sjoen G. Long‐term evaluation of cross‐sex hormone treatment in Transsexual persons. J Sex Med **;**:**–** .
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bone mass bone geometry and body composition in female to male Transsexual persons after long term cross sex hormonal therapy
The Journal of Clinical Endocrinology and Metabolism, 2012Co-Authors: E Van Caenegem, Katrien Wierckx, Youri Taes, David Dedecker, F Van De Peer, Kaatje Toye, Jeanmarc Kaufman, Guy TsjoenAbstract:Context Female-to-male Transsexual persons (Transsexual men) undergo extreme hormonal changes due to ovariectomy and testosterone substitution, allowing studies on sex steroid effects on bone geometry and physiology in the adult. Objective The objective of the study was to examine the effects of cross-gender sex steroid exposure on volumetric bone parameters in Transsexual men. Design This was a cross-sectional study. Setting Participants were recruited from the Center for Sexology and Gender Problems at the Ghent University Hospital (Ghent, Belgium). Participants Fifty Transsexual men after sex reassignment surgery with 50 age-matched control women and an additional 16 Transsexual men before testosterone substitution and sex reassignment surgery with 16 control women participated in the study. Main outcome measures The main outcome measures were areal and volumetric bone parameters using dual-energy X-ray absorptiometry and peripheral quantitative computed tomography, body composition (dual-energy X-ray absorptiometry), sex steroids, markers of bone turnover and grip strength. Results Before hormonal treatment, Transsexual men had similar body composition and bone geometry as female controls. The Transsexual men on long-term testosterone therapy, however, demonstrated a higher lean body mass and muscle mass and a greater grip strength as well as a lower body and subcutaneous fat mass and a larger waist and smaller hip circumference compared with female controls (all P Conclusions Transsexual men on testosterone substitution therapy present with a different body composition with more muscle mass and strength and less fat mass as well as an altered bone geometry with larger bones compared with female controls.
Clemens B Tempfer - One of the best experts on this subject based on the ideXlab platform.
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incidence of thrombophilia and venous thrombosis in Transsexuals under cross sex hormone therapy
Fertility and Sterility, 2010Co-Authors: Johannes Ott, Ulrike Kaufmann, Evakatrin Bentz, Johannes C Huber, Clemens B TempferAbstract:Objective To evaluate the incidence of venous thromboembolism (VTE) in Transsexual patients and the value of screening for thrombophilia in this population. Design Retrospective cohort study. Setting Academic research institution. Patient(s) Two hundred fifty-one Transsexuals (162 male-to-female [MtF] and 89 female-to-male [FtM] Transsexuals). Intervention(s) Screening for activated protein C (aPC) resistance, antithrombin III, free protein S antigen, and protein C deficiency. Main Outcome Measure(s) Incidence of thrombophilic defects and VTE during cross-sex hormone therapy. Result(s) Activated protein C resistance was detected in 18/251 patients (7.2%), and protein C deficiency was detected in one patient (0.4%). None of the patients developed VTE under cross-sex hormone therapy during a mean of 64.2 ± 38.0 months. There was no difference in the incidence of thrombophilia comparing MtF and FtM Transsexuals (8.0% [13/162] vs. 5.6% [5/89], respectively). Conclusion(s) VTE during cross-sex hormone therapy is rare. General screening for thrombophilic defects in Transsexual patients is not recommended. Cross-sex hormone therapy is feasible in MtF as well as in FtM patients with aPC resistance.
Antonio Guillamon - One of the best experts on this subject based on the ideXlab platform.
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effects of cross sex hormone treatment on cortical thickness in Transsexual individuals
The Journal of Sexual Medicine, 2014Co-Authors: Leire Zubiaurreelorza, Carme Junque, Esther Gomezgil, Antonio GuillamonAbstract:Abstract Introduction Untreated Transsexuals have a brain cortical phenotype. Cross-sex hormone treatments are used to masculinize or feminize the bodies of female-to-male (FtMs) or male-to-female (MtFs) Transsexuals, respectively. Aim A longitudinal design was conducted to investigate the effects of treatments on brain cortical thickness (CTh) of FtMs and MtFs. Methods This study investigated 15 female-to-male (FtMs) and 14 male-to-female (MtFs) Transsexuals prior and during at least six months of cross-sex hormone therapy treatment. Brain MRI imaging was performed in a 3-Tesla TIM-TRIO Siemens scanner. T1-weighted images were analyzed with FreeSurfer software to obtain CTh as well as subcortical volumetric values. Main Outcome Measures Changes in brain CTh thickness and volumetry associated to changes in hormonal levels due to cross-sex hormone therapy. Results After testosterone treatment, FtMs showed increases of CTh bilaterally in the postcentral gyrus and unilaterally in the inferior parietal, lingual, pericalcarine, and supramarginal areas of the left hemisphere and the rostral middle frontal and the cuneus region of the right hemisphere. There was a significant positive correlation between the serum testosterone and free testosterone index changes and CTh changes in parieto-temporo-occipital regions. In contrast, MtFs, after estrogens and antiandrogens treatment, showed a general decrease in CTh and subcortical volumetric measures and an increase in the volume of the ventricles. Conclusions Testosterone therapy increases CTh in FtMs. Thickening in cortical regions is associated to changes in testosterone levels. Estrogens and antiandrogens therapy in MtFs is associated to a decrease in the CTh that consequently induces an enlargement of the ventricular system. Zubiaurre-Elorza L, Junque C, Gomez-Gil E, and Guillamon A. Effects of cross-sex hormone treatment on cortical thickness in Transsexual individuals. J Sex Med 2014;11:1248–1261.
