Cross-sex hormone use does not increase cardiovascular risk in young male-to-female transsexuals: a study of self-medication by healthy Thai cabaret dancers

Abstract

Background: Cross-sex hormone (CSH) use is widespread among transsexuals in Thailand. CSHs are used by male-to-female (MtF) transsexuals for feminization. Objectives: To determine effects of self-medication with CSH on cardiovascular risk biomarkers, C-reactive protein (CRP) and fibrinogen (Fb), in Thai MtF transsexuals. Methods: Data were collected from healthy MtF transsexual cabaret dancers in Pattaya city, Thailand, using a questionnaire and descriptive interview. Blood samples were collected to determine lipid profile, CRP, Fb, and sex hormone levels. ANOVA, Pearson correlation, and logistic regression were analyzed for effects of CSH on biomarkers; comparing CSH users with non-using controls. Results: We grouped 102 MtF transsexual participants (average age 28 years) as CSH (n = 66) and non-hormone using controls (n = 36). Several female and antimale hormonal products were used in CSH self-medication, with an average 12.5-year exposure. In the CSH group, significantly higher HDL with lower CRP levels and a negative correlation between total cholesterol, LDL, and 17?-estradiol were observed. Risk prevalence analysis exhibited lower prevalence of disease susceptibility in the CSH group. Logistic regression accordingly revealed the effect of CSH on CRP levels with odds ratios of 0.26 (CI 0.1–0.68) and 0.34 (CI 0.13–0.93) in crude and adjusted models, respectively. Conclusions: Moderate exposure to low doses of CSH use showed no serious risk or health problems in healthy MtF transsexuals in terms of cardiovascular risk biomarkers. Keywords: C-reactive protein, cardiovascular, estrogen, fibrinogen, male-to-female transsexuals progesterone, testosterone