The efficacy, safety, and outcomes of testosterone use among transgender men patients: A review of the literature.

Abstract

Gender dysphoria is the discrepancy between biological sex and gender identity. This can be debilitating for transgender populations, including transgender men (TM), individuals who were assigned female at birth but who identify as men, that can benefit from hormonal therapy with testosterone products to address gender dysphoria. We aim to summarize the efficacy, safety profile, and outcomes of the different testosterone replacement treatment (TRT) in the TM population. A search of the published literature regarding the various FDA-approved TRT was performed in PubMed, Web of Science and Cochrane Library from 2007 to date. We complied two groups of TRT based on route of administration including the conventional testosterone therapies (intramuscular and subcutaneous injectables, and transdermal gels) and newer testosterone therapies (oral, buccal, and nasal gels). For the conventional testosterone therapies, we identified nine studies discussed conventional TRT in TM population including one randomized trial, four prospective studies, one retrospective study and three reviews. For newer testosterone therapies, we identified three studies discussed newer TRT in TM population including one prospective study and two reviews. Articles were then compiled and analyzed. Albeit majority of TRT data stemming from conventional TRT, there appear to be an overwhelmingly safety and efficacy profile in TM population translated with increased free testosterone levels comparable to male range, menses cessation, anxiety/depression decline and improved quality of life. Testosterone therapy can be impactful for TM population with improved safety, efficiency, quality of life and function. With the rise of the newer FDA-approved TRT, randomized studies are warranted to determine its safety and efficacity in this TM population.