Complications of hormonal therapy in male to female transsexuals is uncommon
H Baig1, SJ Iqbal1, R Green2, J Barrett2 & LJ Seal2
Background: Transsexuals in Britain are prescribed hormones as part of Gender Reassignment Treatment. Oestrogen therapy is associated with the development of deep vein thrombosis (DVT) with a 25 fold increased risk, and breast cancer; particularly in the older age group and smokers.
Aims: To investigate the risk of developing deep vein thromboses in male to female transsexual patients who are, or have been, on oestrogen therapy, and seeing if this differs with age, smoking history or route of transmission. The effect on changing the dose on hormone treatment after gender reassignment surgery was also explored.
Method: A retrospective cohort study using the notes of 108 transsexual patients who attended a gender clinic between the dates of Wed 1 January 2003 and 13 June 2003.
Results: 3.95% of male to female patients who had history of oestrogen treatment (MTF+O) developed DVTs, whereas 3.13% of patients with no history of oestrogen treatment (MTF-O) developed DVTs. 5.23% of MTF+O who developed DVTs were smokers, while 5.26% were non smokers. 6.25% of the MTF+O group who developed DVTs were over 40, and no patients under 40 developed DVTs. 4.11% of MTF+O who developed DVTs had a history of oral oestrogen use, and no patients who had taken transdermal oestrogens developed DVTs. No patients in this group developed breast cancer or osteoporosis.
Discussion: There is no significant difference between DVT rates in MTF+O and MTF-O. The incidence is higher for those who were over 40, on oral oestrogens and in non-smokers. There was no difference in the incidence of breast cancer MTF+O and MTF-O, and no difference in the incidence of osteoporosis in all transsexuals who were on oestrogen therapy and those that were not, regardless of the dose taken post operatively.