Morbidity in transsexual patients with cross-gender hormone self-treatment

BACKGROUND: The demand for sex reassignment in transsexual patients has inc reased as have the number of treatments. However, these patients run into t roubles to be treated in Spanish public hospitals and the patients usually make use of self-therapy, without medical control, by suffering frequent si de effects. In this paper, we have analysed these effects. PATIENTS AND METHODS: Cross-sectional and descriptive study of the side eff ects of cross-gender hormone self-administration in 57 transsexuals, aged ( median [SD]) 30(7) years. RESULTS: Combined treatment with estrogen and cyproterone acetate in 31 mal e-to-female transsexuals was associated with hyperprolactinemia in 24/31 pa tients (77.4%) and elevation of liver enzymes in 4/31 (12.9%). Androgen tre atment in 26 female-to-male transsexuals was associated with hyperprolactin emia in 10/26 patients (38.5%), elevation of liver enzymes in 5/26 (19.2%). The levels of total cholesterol, LDL-cholesterol and triglycerides were hi gher in female-to-male that in male-to-female transsexuals (197.3 [40.2] vs 160.6 [38.0] mg/dl, p = 0.033; 131.4 [29.4] vs 104.8 [26.4] mg/dl, p = 0.0 49; and 131.3 [62.7] vs 67.4 [25.6], p = 0.001, respectively). Total choles terol/HDL-cholesterol and LDL-cholesterol/HDL-cholesterol ratios were highe r in female-to-male that in male-to-female transsexuals, too (4.94 [1.20] v s 3.32 [0.71], p = 0.006; and 3.20 [0.87] vs 2.04 [0.63], p = 0.003, respec tively). CONCLUSIONS: The alteration of the cardiovascular risk, the presence of hyp erprolactinemia and the elevation of liver enzymes must be taken into accou nt in transsexual patients with hormone treatment.