• Annals of medicine · Dec 2024

    Assessment of parenteral estradiol and dihydroxyprogesterone use among other feminizing regimens for transgender women: insights on satisfaction with breast development from community-based healthcare services.

    • Toffoli RibeiroCamilaCHospital de Clínicas da Universidade Federal de Uberlândia, Uberlândia, Brazil.Centro de Referência e Assistência Integral para a Saúde Transespecífica (CRAIST) HC/UFU, Uberlândia, Brazil., Ísis Gois, Mariana da Rosa Borges, Lucas Garcia Alves Ferreira, Matheus Brandão Vasco, João Guimarães Ferreira, Taciana Carla Maia, and Magnus Régios Dias-da-Silva.
    • Hospital de Clínicas da Universidade Federal de Uberlândia, Uberlândia, Brazil.
    • Ann. Med. 2024 Dec 1; 56 (1): 24064582406458.

    AbstractThe practice of hormone therapy is crucial in aligning secondary sex characteristics with the gender identity of transgender adults. This study examines the effects of a commonly used injectable hormone combination, specifically estradiol enanthate with dihydroxyprogesterone acetophenide (EEn/DHPA), on serum hormonal levels and self-reported satisfaction with breast development in transwomen. Our research focused on a retrospective longitudinal study involving a large cohort of transwomen evaluated between 2020 and 2022, comprising 101 participants. We assessed serum levels of estradiol (E2), testosterone (T), luteinizing hormone (LH), and follicle-stimulating hormone (FSH), comparing the EEn/DHPA hormonal regimen with other combined estrogen-progestogen (CEP) therapies. Additionally, a subset of 43 transwomen completed a 5-question survey to evaluate self-reported satisfaction with breast development using Tanner scales. Our findings indicated that participants using the EEn/DHPA regimen exhibited significantly higher serum E2 levels (mean: 186 pg/mL ± 32 pg/mL) than those using other therapies (62 ± 7 pg/mL), along with lower FSH levels, but no significant differences in T and LH levels. Concerning satisfaction with breast development, 76% reported increased fulfillment with breast augmentation while using EEn/DHPA. These results suggest that an injectable, low-cost EEn/DHPA administered every three weeks could serve as an alternative feminizing regimen, particularly considering the extensive long-term experience of the local transgender community. Further longitudinal studies on the efficacy of feminizing-body effects and endovascular risks of various parenteral CEP types are warranted to improve primary healthcare provision for transgender persons.

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