Background: Gender affirming hormone therapy (GAHT) leads to profound changes in sex hormone levels, carrying a wide range of implications for major physiological processes in the body. GAHT has been shown to be associated with changes in cardiovascular parameters, the insulin system, body composition, and the psychological state. However, despite the fact that GAHT is usually a long-term intervention, the majority of the research concerns itself with an overall short duration of the therapy and the data on the mid- to long-term effects of GAHT is scarce.
Objectives: The study aims to investigate the effects of gender affirming hormone therapy on the cardiovascular risk profile, insulin system, body composition, various metabolic parameters, and the psychological state after 2, 5, and 10 years of the treatment.
Study design: The study is designed as an observational longitudinal monocentric study, which includes transgender men and transgender women who have been taking gender affirming hormone therapy during the past 2 years and took part in our pilot study. Our probands will undergo a magnetic resonance scan, extensive bloodwork, an oral glucose tolerance test, and a psychological self-assessment after 2, 5, and 10 years of the treatment.
Materials and methods: The magnetic resonance imaging and spectroscopy will be performed with a 3-Tesla magnetic resonance device. We will also perform an extensive blood analysis and an 75g- 2h oral glucose tolerance test. Additionally, the psychological state of the probands will be assessed with 3 questionnaires.
Study population: 30 transgender men 30 transgender women who participated in our pilot study and have been taking the gender affirming hormone therapy for the past 2 years.
Relevance and implications of the study: The majority of previous research has focused on the short-term effects of gender affirming hormone therapy. Contrastingly, our study aims to focus on the effects of hormone therapy at 2, 5 and 10 years after the beginning of the treatment. Moreover, our study group utilizes measurements of myocardial, hepatic, and pancreatic fat content as well as an MR-assisted measurement of cardiac function, which is a topic that has not been present in research into the effects of gender affirming hormone therapy outside of our pilot study.
participation in our pilot study
ongoing gender affirming hormone therapy during the last 2 years
willingness and competence to sign the informed consent form.
age < 18 years
non-MRI conditional implants, grafts, and/or devices
non-MRI conditional tattoos
claustrophobia
Our study aims to enroll transgender probands who took part in our pilot study. 30 transgender women and 30 transgender men will be recruited from the pool of participants in the previous pilot study (EK 1629/2017). The study will include transgender participants between 18 and 99 years of age, who have been taking gender affirming hormone therapy for the past 2 years. The study will not include a placebo group or a control group, and it will not interfere with the gender affirming hormone therapy in any way regarding composition and time course of the treatment.
Cohort
Prospective
gender-affirming hormone therapy
DrugWe are not technically involved in the prescription of gender-affirming hormone therapy. We merely aim at observing effects of GAHT on MRI measured organ lipid content, myocardial mass and function.
Myocardial mass
to examine the effects of gender affirming hormone treatment on myocardial mass (in g/m³)
Cardiac function - LVEF
to examine the effects of gender affirming hormone treatment on left-ventricular ejection fraction (in %) (LVEF) using MR-assisted measurements
cardiac function - cardiac output index
to examine the effects of gender affirming hormone treatment on cardiac output index (in L/min/m²) using MR-assisted measurements
Organ lipid content
to examine the effects of gender affirming hormone treatment on hepatic, pancreatic, and myocardial fat content after 2, 5, and 10 years of the treatment using MR-assisted measurements
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