Transsexual patients, 1989
I. ter Haar
ISSN: 0026-0495
Volume 38, Issue 9 September 1989 Pages 869-873
Mortality and morbidity in transsexual patients with cross-gender
hormone treatment
Asscheman, H; Gooren, L J; Eklund, P L
Department of Internal Medicine, Free University Hospital, Amsterdam,
The Netherlands
Abstract
Sex steroid treatment is associated with side effects. The number of
deaths and morbidity cases in 425 transsexual patients treated with
cross-gender hormones were evaluated retrospectively and compared with
the expected number in a similar reference group of the population.
The number of deaths in male-to-female transsexuals was five times the
number expected, due to increased numbers of suicide and death of
unknown cause. Combined treatment with estrogen and cyproterone
acetate in 303 male-to-female transsexuals was associated with a
45-fold increase of thromboembolic events, hyperprolactinemia
(400-fold), depressive mood changes (15-fold), and transient elevation
of liver enzymes. Androgen treatment in 122 female-to-male
transsexuals was associated with weight increase greater than 10%
(17.2%) and acne (12.3%). In both groups persistent liver enzyme
abnormalities could be attributed to other causes than sex steroids
(hepatitis B and alcohol abuse). Much of the morbidity was minor and
reversible with appropriate treatment or temporary discontinuation of
hormone treatment. Thus, the dilemma of prescribing cross gender
hormones in view of the needs of these patients is not resolved.
Explanation of possible side effects and careful clinical judgment
remain the cornerstone of the clinical decision to prescribe
cross-gender hormones. Furthermore, follow up of this relatively young
population to disclose long-term side effects and to elucidate the
association of sex steroids with coronary heart disease, as well as
efforts to reduce the risk of thromboembolic events, are required.
[Journal Article; In English; United States]
CAS Registry Numbers: Estrogens; Sex Hormones; 2098-66-0, Cyproterone;
427-51-0, Cyproterone Acetate; 57-85-2, Testosterone; 5949-44-0,
testosterone
undecanoate
Citation Subset Indicators: Index Medicus
MeSH Terms: Adolescence; Adult; Aged; Cyproterone - adverse effects
(AE), analogs & derivatives (AA); Cyproterone Acetate; Estrogens -
adverse effects
(AE); Female; Human; Male; Middle Age; Retrospective Studies; Sex
Factors; Sex Hormones - * adverse effects (AE), therapeutic use (TU);
Testosterone -
adverse effects (AE), analogs & derivatives (AA); Transsexualism - *
drug therapy (DT), mortality (MO)
Metabolism: Clinical and Experimental
Volume 38, Issue 9 September 1989 Pages 869-873