Endocrine Abstracts

JOINT2417

Transgender people experience gender dysphoria due to incongruence between their gender indentity and the sex they were assigned at birth. Due to many barriers experienced by transgender people there is no accurate data available, but it is estimated that they represent approximately 0,5% of the Poland population. One of the method to reduce the symptoms of gender dysphoria is hormone therapy, the aim of which is to match a person’s gender characteristics to their identity. The mainstay of therapy for transgender men is testosterone taken as a gel or in the form of regular injections. Type I diabetes is a chronic autoimmune disease underlying which is a process that leads to the gradual destruction of insulin-producing cells of the pancreas. It accounts for about 10% of all cases of diabetes and most often affects children, adolescents and people before the age of 30. Treatment requires the patient to receive continuous insulin administration and regular blood glucose measurements. In recent years, there have been several research papers indicating an up to ninefold higher incidence of type I diabetes in transgender and gender diverse patients. The reasons for this process are unknown. Despite this, there is very little knowledge about the impact of hormone therapy on the course and control of type I diabetes. The effect of testosterone on diabetes control has been studied primarily in cisgender patients with type II diabetes and metabolic syndrome. Single research papers have indicated an initial improvement in the metabolic control of transgender patients after starting hormone therapy with testosterone. We present a description of the observations of two transgender boys, diagnosed with type I diabetes in childhood, who began testosterone therapy at the age of 16. Control of metabolic compensation was carried out through regular clinic visits through two years until they reached adulthood. Our observations indicate a significant improvement in diabetic parameters after the initiation of hormone therapy, especially in terms of lowering glycated hemoglobin, reducing mean blood glucose, and improving self-monitoring and dietary adherence. More studies are needed to describe the effects of hormone therapy on the course and control of type I diabetes and to create guidelines to create inclusive and multispecialty care for transgender and gender diverse children and adolescents with type I diabetes.

Keywords: transgender, gender dysphoria, gender diverse, testosterone, diabetes, autoimmunity, glucose homeostasis