Endocrine Abstracts

Background and Aim: We previously demonstrated (1) that in our transgender clinic, adoptees are significantly overrepresented compared to the general population, suggesting early life traumas may play a role in the etiology of transgenderism. We had also shown a large preponderance (close to 80%) of female sex-assigned-at-birth (SAB), and a trend for presenting for treatment at an older age than non-adopted subjects. In the current study we aimed to further characterize this subgroup by comparing them to contemporary, non-adopted matched control subjects.

Subjects and Methods: Between 01.05.2014 and 31.12.2022, 671 new adult subjects presented to our center for gender-affirming hormonal treatment (GAHT), 14 of whom were adoptees (2.09%). These were matched in a 1:4 for age and SAB, with non-adopted transgender subjects from the same cohort. The 2 groups were compared for multiple psychosocial and life-style characteristics. Comparisons of categorical variables were performed by cross-tabulation statistics.

Results: By design, the current age of subjects (25.0±6.1 y] range 20-40), and the age at initiation of GHAT (22 y [IQR 20-27.5]), were identical, but so was the mean age of dysphoria onset (10 y, range 3-30); 77.1% were transgender men. Groups did not differ with respect to their marital status, altogether 75.7% were single, none had biological children. Adoptees came from families with significantly higher socioeconomic status (SES), 28.6% from high SES vs none among controls. Despite this, none of the adoptees had any college education vs 28.3% of the controls (P=0.028). Employment rate, however, was generally similar in both groups at 72.1% of the cohort. Adoptees tended to carry a psychiatric co-morbidity more often (57.1% vs 28.6%, P=0.061). The number of psychiatric co-morbidities was also higher among adoptees (0.38 per subject vs 0.79, P=0.042). Among non-adopted subjects 62.2% were still living with their parents, as opposed to only 21.4% of adoptees (P=0.013). Lastly, adoptees were more often smokers (57.1% vs 16.4%, P=0.004), and cannabis users (21.4% vs 1.9%, P=0.028).

Conclusion: Adoptees are not only overrepresented among the transgender population treated at our center, but they also have a more fragile psychosocial profile despite coming from higher SES families. These observations might shed some light into the etiology of transition among adoptees that should prompt further exploration. Additionally, they should heighten the attention of clinicians to the vulnerability of this special population.1. Yaish I, Keltch G, Greenman y, Kolitz T, Tordjman K. doi: 10.1210/jendso/ bvad114.2065