Endocrine Abstracts

JOINT1124

Puberty blockers (GnRH analogues) are used to delay pubertal progression in adolescents with gender dysphoria, alleviating distress associated with undesired physical changes. However, concerns about their long-term safety, efficacy, and potential irreversible effects have led to their use being halted for adolescents in the UK, except within the context of approved clinical trials. This study evaluates cardiovascular safety in adolescents on GnRH analogues, with a focus on mean blood pressure measurements obtained through ambulatory blood pressure monitoring (ABPM). Thirteen adolescents (birth-assigned: 6 males, 7 females), including 3 trans men on testosterone therapy, were assessed. Clinic systolic blood pressure (SBP) and 24-hour ABPM were measured. Analyses included comparisons between smokers and non-smokers, correlations between SBP/ABPM and BMI, and differences between trans men with and without testosterone therapy. One patient did not tolerate ABPM, and analyses were conducted for the remaining participants. Clinic SBP and 24-hour ABPM measurements were comparable between birth-assigned males and females (Clinic - Male: 124.8±1.90 mmHg vs Female: 125.6±2.50 mmHg; ABPM - Male: 86.22±2.54 mmHg vs Female: 84.63±1.47 mmHg). Smoking status (tobacco and vape) did not affect clinic SBP or 24-hour ABPM measurements (Clinic - Non-smokers: 123.12±1.52 mmHg vs Smokers: 129.50±3.03 mmHg; ABPM - Non-smokers: 83.57±1.66 mmHg vs Smokers: 88.72±1.32 mmHg). ABPM measurements showed minimal association with BMI (R² = 0.31, P = 0.06). Those assigned female at birth with and without testosterone therapy had similar ABPM results, including awake and asleep periods (Testosterone naive: 85.51±2.20 mmHg vs Testosterone: 83.46±1.54 mmHg). A nocturnal dip >10% was observed in both those birth-assigned male and female. These findings suggest that puberty blockers and, in some cases, testosterone therapy, are safe regarding cardiovascular function in adolescents with gender dysphoria. This study offers valuable evidence supporting the cardiovascular safety of these treatments in this population and underscores the importance of further longitudinal research in larger cohorts to strengthen these conclusions.