ESPE Abstracts

Background: In gender dysphoric adolescents GnRH agonists can be used to suppress pubertal development of the natal sex. Subsequently cross sex hormones can be given to induce pubertal development of the experienced gender. Only few data are available on the safety of this treatment. Lipid levels are known to increase during puberty and pubertal suppression may alter this increase. In gender dysphoric male-to female (MtF) adults oestrogens has been shown to result in a more favourable lipid profile, whereas testosterone treatment in female-to-males (FtM) results in a decrease of HDL cholesterol and an increase of triglycerides.

Objective and hypotheses: This study aimed to determine if GnRH agonist and cross sex hormone treatment of gender dysphoric adolescents influences lipid levels.

Method: During treatment with GnRH agonists and cross sex hormone treatment fasting blood samples were drawn yearly to monitor lipid levels (total cholesterol, LDL- and HDL-cholesterol, and triglycerides). 51 MtF and 67 FtM gender dysphoric adolescents were included at the start of GnRH agonist treatment and 34 MtF and 39 FtM at start of cross sex hormone treatment.

Results: During the 2 years GnRHa treatment a significant increase in total and HDL-cholesterol was found in both sexes. LDL-cholesterol and triglycerides did not change during GnRHa treatment. During the cross-sex hormone treatment a significant decrease in HDL-cholesterol in the FtM group and significant decrease in LDL-cholesterol in the MtF group was found. The other lipid levels did not change significantly.

Conclusion: In gender dysphoric adolescents puberty suppression during 2 years an increase of total and HDL-cholesterol was found. Oestrogen treatment led to a decrease in LDL-cholesterol levels, while testosterone treatment led to a decrease in HDL-cholesterol levels.

Funding: An unrestricted educational grant from Ferring Pharmaceuticals BV, Hoofddorp, the Netherlands.