Transmasculine and gender-diverse patients receiving testosterone as part of their hormone therapy may not be at an increased risk of developing gynecologic cancers in the first years of treatment, according to a recent study published by Vestering et al in eClinicalMedicine.
Background
Many transmasculine and gender-diverse individuals—who are registered as female at birth but do not identify as male, nonbinary, or the traditional image of being female—choose to use testosterone. This type of hormone therapy induces physical changes that are more aligned with their gender identity and/or expression.
Study Methods and Results
In the study, researchers analyzed the risks of endometrial, ovarian, vaginal, and vulvar cancers among 1,955 young transmasculine and gender-diverse patients who received testosterone for an average of 5 years.
“We found no increased risk of these cancers compared [with female individuals] from the general population. None of these cancers were diagnosed in the entire participant group. This is valuable information for both health-care providers and transmasculine and gender-diverse [patients] who are considering starting hormone therapy,” highlighted lead study author Asra Vestering, MD, a researcher at Amsterdam UMC.
Further, the researchers found that in some of the patients, the endometrium was still active or signs of ovulation were observed—despite the use of testosterone. “This is not only relevant for long-term health, but also means that despite testosterone use, there is still a chance of pregnancy. That is why good gynecologic … and contraceptive care remain essential for this group, even after the start of hormone therapy,” emphasized co–study author Wouter van Vugt, MD, MSc, a researcher at Amsterdam UMC.
Conclusions
The findings may offer insights for health-care providers as well as transmasculine and gender-diverse patients who are considering initiating hormone therapy. Although no definitive conclusions can yet be drawn about the effects of long-term testosterone use, the results of the study may offer reassurance in patients who have started or want to start testosterone use.
“This research provides important knowledge for better information and guidance of transmasculine and gender-diverse [patients],” Dr. Vestering underscored. “At the same time, follow-up research into the effects of long-term testosterone use remains necessary, so care can be further tailored to safety and quality of life,” she concluded.
Disclosure: For full disclosures of the study authors, visit thelancet.com.
