Journal article
Reproductive Endocrinology Reference Intervals for Transgender Women on Stable Hormone Therapy
The journal of applied laboratory medicine, Vol.6(1), pp.15-26
03/04/2020
DOI: 10.1093/jalm/jfaa028
PMID: 32674116
Abstract
Abstract Background Transgender women and nonbinary people seeking feminizing therapy are often prescribed estrogen as a gender-affirming hormone, which will alter their reproductive hormone axis. Testosterone, estradiol, and other reproductive hormones are commonly evaluated to assess therapy, but reference intervals specific to transgender women have not been established. The objective of this study was to derive reference intervals for commonly measured analytes related to reproductive endocrinology in a cohort of healthy gender nonconforming individuals on stable feminizing hormone therapy. Methods Healthy transgender individuals who had been prescribed estrogen (n = 93) for at least a year were recruited from internal medicine and primary care clinics that specialize in transgender medical care. Total testosterone and estradiol were measured using immunoassay and mass spectrometry; LH, FSH, sex hormone binding globulin, prolactin, progesterone, anti-mullerian hormone (AMH), and dehydroepiandrosterone sulfate (DHEAS) were measured using immunoassay; free testosterone was calculated. Reference intervals (central 95%) were calculated according to Clinical Laboratory Standards Institute guidelines. Results The distribution of results for transgender women was different than what would be expected from cisgender men or women across all measurements. Use of spironolactone was associated with changes in the result distribution of AMH, FSH, LH, and progesterone. Compared to liquid chromatography coupled to tandem mass spectrometry (LC/MS/MS), immunoassay was sufficient for the majority of estradiol and total testosterone measurements; free testosterone added little clinical value beyond total testosterone. Conclusion Reference intervals specific to transgender women should be applied when evaluating reproductive endocrine analytes. Spironolactone is a significant variable for result interpretation of some tests.
Details
- Title: Subtitle
- Reproductive Endocrinology Reference Intervals for Transgender Women on Stable Hormone Therapy
- Creators
- Dina N Greene - University of WashingtonRobert L Schmidt - University of UtahGabrielle Winston McPherson - University of WashingtonJessica Rongitsch - Capitol Hill Medical, Seattle, WA.Katherine L Imborek - University of Iowa Hospitals and ClinicsJane A DickersonJulia C Drees - The Permanente Medical Group Regional Laboratories, Richmond, CA.Robert M Humble - University of Iowa Hospitals and ClinicsNicole Nisly - University of Iowa Hospitals and ClinicsNancy J Dole - University of Iowa Hospitals and ClinicsSusan K Dane - University of Iowa Hospitals and ClinicsJanice Frerichs - University of Iowa Hospitals and ClinicsMatthew D Krasowski - University of Iowa Hospitals and Clinics
- Resource Type
- Journal article
- Publication Details
- The journal of applied laboratory medicine, Vol.6(1), pp.15-26
- DOI
- 10.1093/jalm/jfaa028
- PMID
- 32674116
- ISSN
- 2576-9456
- eISSN
- 2475-7241
- Grant note
- name: University of Washington, Department of Laboratory Medicine; name: University of Iowa, Department of Pathology
- Language
- English
- Date published
- 03/04/2020
- Academic Unit
- Pathology; Gender, Women's and Sexuality Studies; Family and Community Medicine; General Internal Medicine; Internal Medicine
- Record Identifier
- 9984186392402771
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