Objective The optimum steroid hormone
treatment regimes for transsexual subjects has not yet been established. We
have investigated the mortality and morbidity figures in a large group of
transsexual subjects receiving cross-sex hormone treatment.
Design A retrospective, descriptive
study in a university teaching hospital.
Subjects Eight hundred and sixteen
male-to-female (M-->F) and 293 female-to-male (F-->M) transsexuals.
Interventions Subjects had been
treated with cross-sex hormones for a total of 10,152 patient-years.
Outcome Measures Standardized
mortality and incidence ratios were calculated from the general Dutch
population (age- and gender-adjusted) and were also compared to side effects
of cross-sex hormones in transsexuals reported in the literature.
Results In both the M-->F and
F-->M transsexuals, total mortality was not higher than in the general
population and, largely, the observed mortality could not be related to
hormone treatment. Venous thromboembolism was the major complication in
M-->F transsexuals treated with oral oestrogens and anti-androgens, but
fewer cases were observed since the introduction of transdermal oestradiol
in the treatment of transsexuals over 40 years of age. No cases of breast
carcinoma but one case of prostatic carcinoma were encountered in our
population. No serious morbidity was observed which could be related to
androgen treatment in the F-->M transsexuals.
Conclusion Mortality in
male-to-female and female-to-male transsexuals is not increased during
cross-sex hormone treatment. Transdermal oestradiol administration is
recommended in male-to-female transsexuals, particularly in the population
over 40 years in whom a high incidence of venous thromboembolism was
observed with oral oestrogens. It seems that in view of the deep
psychological needs of transsexuals to undergo sex reassignment, our
treatment schedule of cross-sex hormone administration is acceptably safe.
Citation:
Clin Endocrinol (Oxf) 1997 Sep;47(3):337-42 an
article published on the Internet by PubMed <http://www.ncbi.nlm.nih.gov/>
