Health of Transgender Women: Gynecological, Hormonal, Sexual and Psychological Management

healthtransgenderwomenkapak

METABOLIC CHANGESAFTER HORMONAL TREATMENT IN TRANSGENDER WOMEN

Sercan Kantarcı

Tepecik Training and Research Hospital, Department of Gynecology and Obstetrics, İzmir, Türkiye

Kantarcı S. Metabolic Changes After Hormonal Treatment in Transgender Women. Balsak D, Aksin Ş, eds. Health of Transgender Women: Gynecological, Hormonal, Sexual and Psychological Management. 1st ed. Ankara: Türkiye Klinikleri; 2025. p.27-35.

ABSTRACT

Hormonal therapy in transgender women is a crucial medical intervention aimed at achieving gender congruence, which has profound effects on their metabolic profiles. This treatment typically involves a combination of estrogen and anti-androgens. Estrogen therapy aims to alter secondary sexual charac- teristics and may lead to significant changes in metabolic parameters such as body composition, lipid profile, and insulin sensitivity. The most notable effects of estrogen therapy on the body include alter- ations in fat distribution and muscle mass. While fat tends to accumulate more in certain areas, particu- larly in the hips and thighs, the amount of fat in the abdominal region decreases. Additionally, a marked reduction in muscle mass may occur. These changes generally result in a more feminine body shape.

The impact of estrogen therapy on lipid profiles is also noteworthy. LDL cholesterol levels typical- ly decrease, while HDL cholesterol levels increase. These changes can be considered beneficial for cardiovascular health, as higher levels of HDL cholesterol are associated with a reduced risk of heart disease. However, estrogen therapy also carries potential cardiovascular risks, as it may affect coag- ulation and increase the risk of venous thromboembolism. Therefore, monitoring coagulation status during treatment is important.

Anti-androgen therapy helps to suppress testosterone levels, enhancing the development of femi- nine traits. However, this treatment may lead to a reduction in muscle mass and a decline in physical strength. Furthermore, anti-androgens can improve insulin sensitivity, which may reduce the risk of metabolic syndrome. On the other hand, long-term hormonal therapy may have potential negative effects on bone health, including osteoporosis. Chronic diseases such as cardiovascular diseases, dia- betes, and thrombosis also require careful monitoring during treatment.

The monitoring of metabolic changes during hormonal therapy in transgender women is crucial for managing their overall health. As individual responses to treatment may vary, it is important to per- sonalize the treatment process and regularly monitor health parameters. Early detection of metabolic changes during the long-term hormonal treatment process can help prevent complications.

Keywords: Transgender women; Hormone therapy; Lipid metabolism; Insulin resistance

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