Endocrine Abstracts

Introduction: The number of individuals seeking gender-affirming hormonal treatment (GAHT), as well as the ratio between transgender men and transgender women, has increased over the past two decades. The type of GAHT varies significantly among different countries due to differences in availability and reimbursement policies. We aimed to analyze the kinds of GAHT and demographic characteristics of transgender adults at our endocrine clinic, the only center caring for transgender adults in Slovenia.

Methods: A retrospective analysis of the baseline demographic characteristics and GAHT type of transgender adults at our endocrine clinic from 2016 to 2022 was performed.

Results: From January 2016 until December 2022, 141 transgender adults (66 transgender women and 75 transgender men) were examined at our clinic. Transgender men were significantly younger at their first visit, with average age of 24.11 (6.51) vs. 31.35 (10.34) years for transgender women; P<0.01. The baseline BMI did not differ significantly between the two groups: for transgender men, BMI was 23.96 (5.61) kg/m² vs. transgender women 23.25 (4.24) kg/m². Transgender men use transdermal testosterone in 25% and depo testosterone undecanoate in 52%. We have lost follow-up for 10%, and 13% haven’t started with testosterone therapy yet. Transgender women use anti-androgen treatment in 53% (25% have already had gender-affirming surgery, 10% haven’t started with treatment yet, we have lost follow-up for 8%, and 6% refuse to use antiandrogen therapy). Half (54%) use cyproterone acetate, 42% spironolactone, and only one uses GnRH agonist. As for estrogen therapy, 56% of transgender women use peroral estradiol, 31% transdermal estradiol, and 13% intramuscular estradiol valerate.

Conclusion: Our analysis shows a slight predominance of transgender men receiving GAHT in Slovenia. They are significantly younger than transgender women when they first seek GAHT. At baseline, transgender men do not differ in BMI from transgender women. More than half of transgender men use intramuscular depo testosterone. About the same number of transgender women use cyproterone acetate and spironolactone as antiandrogen therapy. Over half of transgender women use peroral estradiol, and about a third use transdermal estradiol. So far, only a minority use intramuscular estradiol valerate.