Patterns of Use of Endocrine and Hormonal Therapy in Patients with Gender Dysphoria [ID 2683388

Abstract

INTRODUCTION: Gender dysphoria (GD) is the emotional distress experienced by transgender individuals. While hormonal and endocrine therapy has been shown to improve outcomes, there is a paucity of data assessing patterns of use. The objective of our study was to determine trends in use of therapy in patients with GD. METHODS: We utilized the MarketScan Research Databases to identify patients aged 18–64 years with GD from 2008 to 2021. Use of guideline-recommended hormonal therapy including testosterone for transgender males and estradiol, spironolactone, and GnRH agonists for transgender females was examined. Patients were included if they had at least one full year of continuous insurance and drug enrollment. The utilization rate of each agent for each given year and duration of the first hormonal treatment were examined. RESULTS: A total of 36,847 patients were identified. The cohort included 18,195 (49.4%) patients with self-reported gender as male, and 18,652 (50.6%) as female. Overall, 61.0% of the cohort used hormonal therapy including estradiol in 33.4%, spironolactone in 27.3%, testosterone in 25.7%, and GnRH agonists in 0.3%. Use of hormonal therapy increased in more recent years of the study. Overall, hormonal therapy was used in 55.9% of those aged 18–24 years, 64.3% of those 25–34 years, 66.8% of patients 35–44 years, 64.2% of those 45–54 years, and in 61.5% of patients aged 55–64 years. CONCLUSION: The use of endocrine and hormonal therapy among transgender individuals is substantial and has increased over the last decade.