Transsexualism is defined by âthe desire to live and be accepted as a member of the opposite sex, accompanied by the wish to transform the body as congruent as possible to the preferred sex through surgery and hormone treatment (HT)â. The prevalence is estimated to be 1:100000 females and 1:30000 males. The etiology of transsexualism remains uncertain. While some authors hypothesise a biological cause, others favour a psycho-social etiology. The proposed treatment for transsexual people encompasses five steps. Firstly, the diagnosis must be confirmed and, in parallel, the patient undergoes psychotherapy. In the next phase, the patients âtestâ their new gender role and consolidate it. Cross-sex HT is initiated and sex-reassignment surgery follows. Long-term follow-up is recommended with regular medical visits. In the present study, we investigated a large sample of transsexuals receiving HT, to determine whether they are at an increased risk of developing a wide range of diseases such as cardiovascular, endocrine or tumoural diseases. As gender had been reassigned for these patients, we contrasted our findings with female and male age-matched control samples. There is limited data on safety aspects of hormonal treatment in transsexual patients and clinical trials are lacking. We aimed at evaluating the long-term hormonal treatment in transsexual patients. 95 transsexuals (37 female-to-male (FMT) and 58 male-to-female transsexuals (MFT)) treated between 1996 and 2007 were compared to an age- and gender-matched primary care patient group from the DETECT-cohort (matching 1:3). Compared to age-matched control groups, we did not observe a higher prevalence of lifetime cardiovascular, endocrine or tumoural comorbidities. FMT showed a lower prevalence of endocrine diseases (FMT to females, p=0.008 and FMT to males, p=0.033). MFT showed a lower prevalence of cardiovascular diseases (MFT to females, p=0.005 and MFT to males, p<0.001) and endocrine diseases (MFT to females p<0.001 and MFT to males, p<0.001). There is no indication of an increased risk associated with HT in transsexual patients in Germany. In summary, and despite these limitations and remaining reservations, we found no indication for an increased risk associated with HT of upto 10 years duration in transsexual patients in Germany. However, clinical trials, evaluating even longer periods of treatment to determine safety and the use of completely healthy controls, are
required. Comorbidities in Transsexual Patients under Hormonal Treatment Compared to Age- And Gender-Matched Primary Care Comparison Groups: MarÃa Ãngeles Bazarra-Castro, Caroline Sievers, Stephany Fulda, Jens Klotsche, Lars Pieper, Hans-Ulrich Wittchen and GÃ¼nter Karl Stalla.
Last date updated on June, 2014