Endocrine Abstracts

JOINT3602

Background: Gender-affirming hormone therapy (GAHT) is guided by personalized patient objectives/goals, lab-based clinical monitoring, and safety considerations. Guidelines incorporate laboratory-based monitoring and safety data but encounter challenges when integrating patient goals into research, as patient goals are non-standardized and subjective. Key patient goals should be identified, integrated into clinical trials, and should be prioritized in endpoints of research; this could increase the relevance of research findings for clinical practice. This study aims to address this gap by exploring the personal goals and needs of transgender and gender diverse individuals regarding gender affirming hormone therapy, emphasizing the inclusion of gender diverse individuals’ perspectives, which remain largely understudied.

Method: Following comprehensive literature research, we developed an anonymous, cross-sectional web-based online survey in collaboration with professionals and community representatives. Our target population was transgender and gender diverse individuals above age 16 who were currently undergoing, planned to start, or stopped GAHT. In addition to sociodemographic questions, participants rated predefined goals (physical changes, quality of life, sexuality, reduced gender dysphoria, safety) on a scale from 1 to 10 and then ranked them by priority (most important, 2nd most important, etc.). If these goals didn’t apply, they could specify a personal goal.

Result: Between May and September 2024, 738 individuals participated in the survey (407 transmasculine, 304 transfeminine, and 27 other gender identities). The median age was 25 [21-31] for transmasculine and 29 [25-39] for transfeminine participants. A total of 229 (56.3%) transmasculine and 106 (34.9%) transfeminine individuals identified as non-binary. Regarding hormone therapy, 75.4% of transmasculine and 86.8% of transfeminine individuals were currently receiving treatment. The most frequently reported primary goal of gender-affirming hormone therapy (GAHT) varied by gender identity. While physical changes were prioritized by binary transgender and gender diverse participants, non-binary transgender and gender diverse participants had more diverse goals, including quality of life and reducing gender dysphoria. Prioritization of treatment outcomes also reflected this variation, with sexuality and safety ranked lower across all groups.

Conclusion: Our findings help caretakers by guiding conversation with transgender and gender diverse individuals in terms of GAHT and informing future research priorities. Further, therapy goals differ significantly between binary and non-binary transgender and gender diverse individuals. Considering these diverse needs, especially those of non-binary individuals, can enhance gender-affirming care.