Session: MON 586-595-Reproductive Axis Determination, Development & Transgender Medicine
Poster Board MON-593
N Lopez 1, C Ramirez1, H Vega 2, V Rodriguez 3, G Hernandez 3, J Cruz 2, A Gonzalez 4, F Badiano 4,
- MD, Endocrinologist. Endocrinology Department, Clinica Especializada Condesa, Mexico City.
- MD, Psychiatrist. Mental Health Department, Clinica Especializada Condesa, Mexico City.
- Psychologist. Mental Health Department, Clinica Especializada Condesa, Mexico City.
- HIV program, Clinica Especializada Condesa, Mexico City
Background: In Mexico, specialized transgender medical care is costly and rare. Estrogen, progesterone and testosterone are known to increase the cardiovascular risk in normal conditions and these populations use more over-the-counter hormones in high doses which increases this risk.
Materials and methods: 753 files were reviewed for complete clinical information from July 2009 to December 2012. We performed statistical tests in SPSS v. 14 with a significant p<0.05.
Results: 300 files with diagnosis of transgenderism or transsexualism had complete laboratory results at baseline, 90% were MtF. Only MtF patients were HIV positive (35.6% vs 0% FtM, p<0.001), they were older at first evaluation (31 vs 23 years, p<0.001), and used more over-the-counter hormones (MtF 70 vs FtM27%). Endocrine disturbances were common: overweight or obesity (40%), 20% had abnormal fasting glucose or diabetes, 17% high total cholesterol and 23% high triglycerides. Seropositive patients had higher frequencies of low HDL cholesterol (50% vs. 18.3%). Hypertension was present only in 0.8%. The average baseline hormones levels in MtF [mean + standard deviation]: LH (3.43±6.04mUI/mL), FSH (5.58±12.59 mUI/mL), prolactin (33.37±28.91 ng/mL), testosterone (3.35±3.45 ng/mL) and estradiol (94.92± 132.78 pg/mL). In FtM [mean + standard deviation] LH (7.17±6.59mUI/mL), FSH (4.22±3.34 mUI/mL), prolactin (24.62±11.12 ng/mL), testosterone (4.25±5.82 ng/mL) and estradiol (84.09± 55.7 pg/mL).
Discussion: The prevalence of obesity and cholesterol disorders in this population are similar from that reported in the National Health Survey 2012 (ENSANUT), but higher than reported worldwide. Hypertension may be underestimated in this group. MtF had the lowest gonadotropin and testosterone level, while FtM had the inverse profile (p<0.001). Estradiol levels where similar in all groups, probably because MtF tend to use irregular over-the-counter treatments.
Conclusions: Risk factors for cardiovascular disease are highly prevalent in Mexican trans population. Combination with high doses of hormones may predispose to higher cardiovascular risk. This group’s characteristics are different from the usual international reports. Long term follow up, interventions, investments and legislation in these areas may be needed to reduce future morbidities.
Nothing to Disclose: NLJ, CR, HV, VR, GH, AG, FB
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