Endocrine Abstracts

JOINT967

Introduction: The first unit for transgender health-care within the Spanish public health system was created in 1999 in Andalusia. The Transgender Care Unit (TCU) of Malaga is functionally dependent on the Endocrinology and Nutrition service and is composed of a multidisciplinary team, including specialists in Endocrinology, Clinical Psychology, Plastic Surgery, Gynecology, Urology, Otorhinolaryngology, and Phoniatrics.

Objective: To compare the sociodemographic profile of transgender people undergoing endocrinological follow-up at the TCU of Malaga during the period from 1999 to 2024.

Methodology: Descriptive, retrospective, and cross-sectional study that include transgender people under endocrinological follow-up at the TCU of Malaga from 1999-2024. The inicial assessment is performed by Endocrinology for individuals over 14 years of age, with psychological evaluations being voluntary in accordance with current legislation. The collected data included the number of consultations (initial and follow-up) in the last two years, the mean age ± standard deviation at the first consultation, the ratio of transgender women/transgender men (MTF/FTM), the frequency of psychopathology, and the psychological support received.

Results: The number of consultations has increased exponentially, reaching 1,609 and 1,794 consultations per year in 2023 and 2024, respectively. First consultations accounted for 18% of visits, while the remaining 82% were follow-ups. The average age of individuals attending for the first time has decreased, from 28.5 years in the first decade to a range of 22.2–23.9 years in 2023–2024. The proportion of individuals under 18 years old increased from 8.2% in the first decade to 30% in the second decade, reaching 40% in 2024. A reversal in the biological sex ratio of individuals seeking transition was also observed. The MTF/FTM ratio initially stood at 2.45 but gradually decreased to a ratio of 0.66 in 2024, with 39.5% identifying as MTF and 60.5% as FTM. It is noteworthy that a high percentage of individuals presented psychopathology (43–50%). The most common conditions were anxiety-depression disorder, attention deficit hyperactivity disorder, and autism spectrum disorder. The rate of suicidal ideation and/or attempts was 22%. The majority of people (50.6% to 80.8% in 2023–2024) accepted receiving psychological support at the onset of their medical transition.

Conclusion: The high demand for health-care by transgender people, combined with the significant proportion of minors with psychopathology, highlights the complexity of assessing the gender identity. It is essential to provide transgender care in specialized multidisciplinary teams.