Expected vs. perceived effects of gender-affirming hormone therapy among transmasculine adolescents
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Valerie Taillefer
Abstract
Objectives
Gender-affirming testosterone therapy is increasingly prescribed among transmasculine adolescents and has been associated with improved mental health outcomes. However, expected and perceived effects of testosterone have not previously been compared in this population.
Methods
We compared desired and reported effects of testosterone in all consecutive transmasculine adolescents followed at a large interdisciplinary gender diversity clinic in North America. Participants received a prescription for testosterone and were first seen between November 2016 and May 2021. Our study was a retrospective audit of case notes. We collected self-reported desired effects prior to initiation of testosterone and self-reported perceived effects from participants’ medical records up to 24 months after initiation. The masculinizing effects of testosterone considered in our study were increased body/facial hair, voice deepening/Adam’s apple growth, increased muscle mass, clitoromegaly, and body fat redistribution.
Results
There were 76 participants included in this study. Mean age at prescription of testosterone was 16.31 years (standard deviation: 0.99 years). The effects desired by the greatest proportion of participants prior to initiation were increased body/facial hair (69 %) and voice deepening/Adam’s apple growth (52 %). These same two effects were the most reported by participants, reaching 80 % report rates at 12 months, and increasing steadily across the 24-month follow-up period.
Conclusions
Our study shows that for most, but not all gender diverse adolescents undergoing testosterone therapy, the most expected physical changes were seen in the first year of gender-affirming treatment. More research and provider education are needed to offer optimal counseling for adolescents undergoing gender-affirming hormone therapy.
Acknowledgments
The authors would like to thank the members of the Canada Research Chair on Transgender Children and their Families’ permanent Consultation Committee for their invaluable support in the design of this study. The authors would also like to thank Ms. Masoumeh Sajedi for her contribution to statistical analyses.
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Research ethics: The project received ethics approval from Sainte-Justine University Hospital Centre Research Ethics Board.
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Informed consent: Informed consent was obtained from all individuals included in this study.
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Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
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Competing interests: Authors state no conflict of interest.
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Research funding: None declared.
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Articles in the same Issue
- Frontmatter
- Review
- Clinical heterogeneity and therapeutic options for idiopathic infantile hypercalcemia caused by CYP24A1 pathogenic variant
- Original Articles
- Growth hormone use in pediatric inflammatory bowel disease
- Extremely and very preterm children who were born appropriate for gestational age show no differences in cortisol concentrations or diurnal rhythms compared to full-term children
- A prospective comparison study of subcutaneous and intramuscular testosterone injections in transgender male adolescents
- Excess body weight and dyslipidemia at well-child visit
- Body mass index evolution and ovarian function in adolescent girls who received GnRH agonist treatment for central precocious puberty or early and fast puberty
- Assessment of pubertal onset and disorders of puberty in Indian children and youth with type-1 diabetes
- A different approach to the evaluation of the genotype-phenotype relationship in biotinidase deficiency: repeated measurement of biotinidase enzyme activity
- Expected vs. perceived effects of gender-affirming hormone therapy among transmasculine adolescents
- Developmental scores in offspring of women with subclinical hypothyroidism in pregnancy are affected by gender and thyrotropin cutoff
- Assessment of the diagnosis, treatment, and follow-up of a group of Turkish pediatric glycogen storage disease type 1b patients with varying clinical presentations and a novel mutation
- IGAm: A novel index predicting long-term survival in patients with early-diagnosed inherited metabolic disorders
- Case Report
- Persistent hypercalcemia mimicking hypophosphatasia after discontinuation of a ketogenic diet: a case report
Articles in the same Issue
- Frontmatter
- Review
- Clinical heterogeneity and therapeutic options for idiopathic infantile hypercalcemia caused by CYP24A1 pathogenic variant
- Original Articles
- Growth hormone use in pediatric inflammatory bowel disease
- Extremely and very preterm children who were born appropriate for gestational age show no differences in cortisol concentrations or diurnal rhythms compared to full-term children
- A prospective comparison study of subcutaneous and intramuscular testosterone injections in transgender male adolescents
- Excess body weight and dyslipidemia at well-child visit
- Body mass index evolution and ovarian function in adolescent girls who received GnRH agonist treatment for central precocious puberty or early and fast puberty
- Assessment of pubertal onset and disorders of puberty in Indian children and youth with type-1 diabetes
- A different approach to the evaluation of the genotype-phenotype relationship in biotinidase deficiency: repeated measurement of biotinidase enzyme activity
- Expected vs. perceived effects of gender-affirming hormone therapy among transmasculine adolescents
- Developmental scores in offspring of women with subclinical hypothyroidism in pregnancy are affected by gender and thyrotropin cutoff
- Assessment of the diagnosis, treatment, and follow-up of a group of Turkish pediatric glycogen storage disease type 1b patients with varying clinical presentations and a novel mutation
- IGAm: A novel index predicting long-term survival in patients with early-diagnosed inherited metabolic disorders
- Case Report
- Persistent hypercalcemia mimicking hypophosphatasia after discontinuation of a ketogenic diet: a case report
