Valoración del tratamiento hormonal cruzado en transexuales: experiencia de una unidad de trastornos de identidad de género

Abstract

IntroductionThe Unit of Gender Identity Disorders (UTIG) of the Hospital Ramón y Cajal is responsible for the diagnosis, endocrinological and surgical treatment, and monitoring of transsexuality, and is a referral center for Madrid regarding the treatment of gender dysphorias. The research in this field is becoming more noticeable as it grows the social and professional acceptance, and increased knowledge about the complex hypothalamus-pituitary-gonadal axis. Material and methodsThis is a longitudinal descriptive study, with patients who were tracked at UTIG of Hospital Ramón y Cajal, in the period between May 2007 and March 2009 (23 months). The clinical, biochemical and hormonal monitoring was performed every three months. We initially included 148 patients, of which 34 were excluded, for initial evaluation. Eventually included in the study 110 patients and who met the inclusion criteria. ResultsIn the group of female transsexuals after serving one year of cross-sex hormonal treatment, LH and FSH showed a slight increase, but was not significant. Any differences after one year of treatment in the basal levels of cortisol and ACTH were observed. In male transsexuals, after one year cross-sex hormonal treatment, FSH increased slightly during treatment, although these changes were not significants. However, a significant increase in LH levels was observed. This change did not correlate with the levels of estradiol. We determined a relative increase in the levels of ACTH and cortisol. ConclusionsThere are unknown factors in the regulation of hypothalamic-pituitary-gonadal and hypothalamic-pituitary-adrenal axis in transsexual people. These factors appear to have involved at all levels. Can be a source of long-term studies. Analytical studies are lacking to assess the actual effect of the parameters studied on the mortality of these patients.