ESPE Abstracts (2015) 84 P-2-263

Insulin Sensitivity in Adolescents with Gender Dysphoria During Puberty Suppressing Therapy with GnRH Agonists

Sebastian Schagena,b, Henriette Delemarre-van de Waala,b & Sabine Hannemaa


aDepartment of Pediatrics, LUMC, Leiden, The Netherlands; bDepartment of pediatric endocrinology, VUMC, Amsterdam, The Netherlands


Background: In gender dysphoric adolescents GnRH agonists can be used to suppress pubertal development of the natal sex. The metabolic implications of the pubertal suppression have not yet been explored. Insulin sensitivity is known to be influenced by pubertal changes. During puberty a decrease in insulin sensitivity is normally observed.

Objective and hypotheses: The effects of GnRH agonists on insulin sensitivity during 2 years of treatment in adolescents with gender dysphoria were examined. We hypothesized that withdrawal of sex steroids by centrally blocking the gonadotropic axis would cause insulin sensitivity to increase.

Method: 91 adolescents with GD, 41 male-to-females (MtF) and 50 female-to-males (FtM) receiving 3.75 mg of the GnRH agonist triptorelin every 4 weeks, were studied by determining insulin sensitivity (QUICKI) using fasting glucose and insulin serum levels.

Results: QUICKI (estimated marginal means+SE) at the start of treatment was 0.351 (0.005) in MtF, 0.354 (0.004) in FtM and after 2 years 0.354 (0.004) in MtF and 0.358 (0.006) in FtM.

Conclusion: No significant change in insulin sensitivity occurred during 2 years of treatment with puberty suppressing therapy in genderdysphoric adolescents using GnRH agonists.

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

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