ABSTRACT
BACKGROUND AND AIMS: Since the onset of cross hormone therapy (CHT) in transsexual individuals, there has been concern about possible chronic side effects. Our objective was to assess baseline differences in lipid profile in individuals with gender identity disorder in relation to prior CHT, and changes in the lipid profile and other cardiovascular (CV) risk factors after 24 months of treatment. Methods: Retrospective longitudinal study including all individuals assisted for the first time in the Gender Identity Unit of Catalonia from 2006 to 2010. Socio-demographical, anthropometric and laboratory data were collected. Results: We evaluated 247 transsexuals, 150 male to female (MtF: 60.7%) and 97 female to male (FtM; 39.3%). At baseline, FtM transsexuals were younger and had started prior CHT less often than MtF (13.4% vs. 64.7%; p < 0.001). During follow up, in MtF weight and BMI increased significantly, as well as systolic and diastolic blood pressure, though these latter remained within normal range. No significant differences in lipid profile were observed. FtM transsexuals also presented an increase in weight and BMI, without differences in blood pressure. A general worsening in lipid profile was observed in this group, with increased total cholesterol (166.0 ± 35.1 vs. 175.6 ± 38.2 mg/dL; p = 0.001), triglycerides (70.6 ± 30.7 vs. 102.3 ± 68.5 mg/dL; p < 0.001) and LDL cholesterol (103.8 ± 28.7 vs. 112.8 ± 30.3 mg/dL; p = .013) and decreased HDL cholesterol (52.2 ± 12.2 vs. 45.4 ± 13.8 mg/dL;p = 0.001), even though final levels were all within normal range. Conclusion: There is no detectable increase in CV risk factors in MtF transsexuals who were treated with currently prescribed estrogenic compounds, while a slight worsening in lipid profile takes place in the FtM group, though within normal limits
ANTECEDENTES Y OBJETIVOS: Desde la introducción del tratamiento hormonal cruzado (CHT) en los individuos transexuales existe preocupación sobre sus posibles efectos secundarios a largo plazo. Nuestro objetivo fue evaluar las diferencias en el perfil lipídico basal de individuos transexuales en relación con haber realizado o no CHT previo, y los cambios en dicho perfil y en otros factores de riesgo cardiovascular (FRCV) tras 24 meses de tratamiento. MÉTODOS: Estudio longitudinal retrospectivo incluyendo todos los pacientes atendidos como primera visita en nuestra unidad entre 2006 y 2010. Se recogieron datos socio-demográficos, antropométricos y de laboratorio. RESULTADOS: Se evaluaron 247 transexuales, 150 de hombre a mujer (MtF: 60.7%) y 97 de mujer a hombre (FtM: 39.3%). Basalmente, los transexuales FtM eran más jóvenes y habían realizado CHT previamente con mayor frecuencia (13.4% vs. 64.7%; p < 0.001). Durante el seguimiento el peso y el IMC aumentaron en MtF de forma significativa, así como la tensión arterial sistólica y diastólica, aunque estos dos últimos se mantuvieron dentro de la normalidad. No se objetivaron diferencias significativas en el perfil lipídico. Los transexuales FtM también presentaron un incremento de peso e IMC, sin diferencias en la tensión arterial. Se observó un empeoramiento generalizado del perfil lipídico en este grupo, con aumento del colesterol total (166.0 ± 35.1 vs. 175.6 ± 38.2 mg/dL; p = 0.001), triglicéridos (70.6 ± 30.7 vs. 102.3 ± 68.5 mg/dL; p < 0.001) y colesterol LDL y empeoramiento del colesterol HDL (52.2 ± 12.2 vs. 45.4 ± 13.8 mg/dL; p = 0.001). CONCLUSIÓN: No se produce un incremento significativo en los FRCV en los transexuales MtF tratados con los compuestos estrogénicos actuales, mientras que se observa un discreto empeoramiento en el perfil lipídico en los transexuales FtM, aunque los valores se mantienen dentro de la normalidad
Subject(s)
Humans , Cardiovascular Diseases/prevention & control , Gonadal Steroid Hormones/pharmacokinetics , Risk Factors , Transsexualism/drug therapy , Retrospective Studies , Lipids/blood , Hyperlipidemias/prevention & control , Time/statistics & numerical dataABSTRACT
BACKGROUND AND AIMS: Since the onset of cross hormone therapy (CHT) in transsexual individuals, there has been concern about possible chronic side effects. Our objective was to assess baseline differences in lipid profile in individuals with gender identity disorder in relation to prior CHT, and changes in the lipid profile and other cardiovascular (CV) risk factors after 24 months of treatment. METHODS: Retrospective longitudinal study including all individuals assisted for the first time in the Gender Identity Unit of Catalonia from 2006 to 2010. Socio-demographical, anthropometric and laboratory data were collected. RESULTS: We evaluated 247 transsexuals, 150 male to female (MtF: 60.7%) and 97 female to male (FtM; 39.3%). At baseline, FtM transsexuals were younger and had started prior CHT less often than MtF (13.4% vs. 64.7%; p<0.001). During follow up, in MtF weight and BMI increased significantly, as well as systolic and diastolic blood pressure, though these latter remained within normal range. No significant differences in lipid profile were observed. FtM transsexuals also presented an increase in weight and BMI, without differences in blood pressure. A general worsening in lipid profile was observed in this group, with increased total cholesterol (166.0 ± 35.1 vs. 175.6 ± 38.2mg/dL; p=0.001), triglycerides (70.6 ± 30.7 vs. 102.3 ± 68.5 mg/dL; p<0.001) and LDL cholesterol (103.8 ± 28.7 vs. 112.8 ± 30.3 mg/dL; p=.013) and decreased HDL cholesterol (52.2 ± 12.2 vs. 45.4 ± 13.8 mg/dL; p=0.001), even though final levels were all within normal range. CONCLUSION: There is no detectable increase in CV risk factors in MtF transsexuals who were treated with currently prescribed estrogenic compounds, while a slight worsening in lipid profile takes place in the FtM group, though within normal limits.
Subject(s)
Cardiovascular Diseases/epidemiology , Dyslipidemias/chemically induced , Gonadal Steroid Hormones/pharmacology , Lipid Metabolism/drug effects , Transgender Persons , Transsexualism/blood , Adult , Androgens/adverse effects , Androgens/pharmacology , Blood Pressure/drug effects , Body Mass Index , Cardiovascular Diseases/etiology , Dyslipidemias/epidemiology , Emigrants and Immigrants , Estrogens/pharmacology , Female , Gonadal Steroid Hormones/adverse effects , Health Services for Transgender Persons/statistics & numerical data , Humans , Lipids/blood , Male , Retrospective Studies , Risk Factors , Smoking/epidemiology , Spain/epidemiology , Young AdultABSTRACT
INTRODUCTION: The aim of the present study was to evaluate the presence of symptoms of current social distress, anxiety and depression in transsexuals. METHODS: We investigated a group of 187 transsexual patients attending a gender identity unit; 120 had undergone hormonal sex-reassignment (SR) treatment and 67 had not. We used the Social Anxiety and Distress Scale (SADS) for assessing social anxiety and the Hospital Anxiety and Depression Scale (HADS) for evaluating current depression and anxiety. RESULTS: The mean SADS and HADS scores were in the normal range except for the HAD-Anxiety subscale (HAD-A) on the non-treated transsexual group. SADS, HAD-A, and HAD-Depression (HAD-D) mean scores were significantly higher among patients who had not begun cross-sex hormonal treatment compared with patients in hormonal treatment (F=4.362, p=.038; F=14.589, p=.001; F=9.523, p=.002 respectively). Similarly, current symptoms of anxiety and depression were present in a significantly higher percentage of untreated patients than in treated patients (61% vs. 33% and 31% vs. 8% respectively). CONCLUSIONS: The results suggest that most transsexual patients attending a gender identity unit reported subclinical levels of social distress, anxiety, and depression. Moreover, patients under cross-sex hormonal treatment displayed a lower prevalence of these symptoms than patients who had not initiated hormonal therapy. Although the findings do not conclusively demonstrate a direct positive effect of hormone treatment in transsexuals, initiating this treatment may be associated with better mental health of these patients.
Subject(s)
Anxiety/drug therapy , Depression/drug therapy , Estrogens/therapeutic use , Stress, Psychological/drug therapy , Testosterone/therapeutic use , Transsexualism/drug therapy , Adolescent , Adult , Anxiety/psychology , Depression/psychology , Female , Gender Identity , Humans , Male , Sex Reassignment Surgery , Stress, Psychological/psychology , Surveys and Questionnaires , Transsexualism/psychology , Young AdultABSTRACT
The aim of this study was to examine the characteristics of transsexuals from Spain. A total of 252 consecutive applicants for sex reassignment were evaluated using a standardized semistructured clinical interview and the Mini International Neuropsychiatric Interview (Spanish Version 5.0.0) to record demographic, clinical, and psychiatric data. Transsexualism was diagnosed in 230 patients, with a male to female (MF)/female to male (FM) ratio of 2.2:1. Transsexual patients frequently had low employment status, lived with their parents, and mainly had a sexual orientation toward same-sex partners. The most frequent psychiatric diagnoses were adjustment disorder and social phobia in both groups, and alcohol and substance-related disorders in the MF group. MF transsexuals were older than FM transsexuals when requesting sex reassignment, but did not differ in age when starting hormonal therapy (often on their own); fewer MFs were in employment requiring high educational qualification, more were non-Spanish natives, and more had previous and current histories of alcohol and substance abuse or dependence. The basic characteristics of transsexuals from Spain were similar to those of other European countries, except for the higher proportion of patients living with their parents and the higher proportion of MFs who reported same-sex sexual orientation compared with previous studies.
Subject(s)
Transsexualism/epidemiology , Transsexualism/psychology , Adjustment Disorders/epidemiology , Female , Hormone Replacement Therapy , Housing , Humans , Interview, Psychological , Male , Parents , Sexual Behavior/psychology , Socioeconomic Factors , Spain/epidemiology , Substance-Related Disorders , Transsexualism/surgeryABSTRACT
Objetivo: Evaluar el grado de psicopatología en pacientestransexuales, y determinar las diferencias en funcióndel género (transexuales de hombre-a-mujer y de mujera-hombre).Sujetos y Método: Se administró el Inventario Multifásicode Personalidad Minnesota-2 (MMPI-2) a 100 pacientesdiagnosticados de transexualismo o trastorno de laidentidad de género (ICD-10, DSM-IV TR,). Los pacientesfueron agrupados en función del género en 70 transexualesde hombre-a-mujer (H-M) y 30 de mujer-a-hombre (MH).Resultados: Las puntuaciones T medias de todas lasescalas se encontraron dentro del rango de normalidadexcepto la escala de Masculinidad-feminidad (T=65 parael grupo hombre-a-mujer y T=66 para el grupo mujer-ahombre).No se encontraron diferencias significativas enfunción del género ni en las puntaciones medias T decada escala, ni en el porcentaje de pacientes con puntuacionesT>=65.Conclusiones: Los resultados sugieren que 1. los pacientestransexuales candidatos a reasignación sexual enconjunto se encuentran libres de psicopatología y 2. nose encuentran diferencias en el grado de psicopatologíaentre los grupos hombre-a-mujer y mujer-a-hombre. Esteestudio por lo tanto no apoya la hipótesis de que eltransexual en proceso de reasignacion sexual presentealteraciones emocionales relevantes
Objective: To evaluate the degree of psychopathologyamong male-to-female and female-to-male transsexuals.Method: Minnesota Multiphasic Personality Inventory-2(MMPI-2) were administered to 100 sex change applicantswho had been diagnosed as transsexualism accordingICD-10 and DSM-IV TR (70 transsexuals male-to-femaleand 30 female-to-male).Results: Mean T scores from the MMPI-2 were within thenormal range except for the Masculinity-feminity scale(T=65 for the M-F group and T= 66 for the F-M group).Male-to-female transsexuals did not differ significantly inmean T scores nor in the percentage of patients with T>=65from the female-to-male transsexual group.Conclusions: Results support the view that 1) transsexualscandidates to sex reassignment were notably free ofpsychopathology, and 2) male-to-female versus femaleto-male did not differ in degree of psychophatology. Thus,the study reject the hypothesis that transsexuals in processof sex reassignment suffer major emotional disturbances
Subject(s)
Male , Female , Adult , Humans , MMPI/statistics & numerical data , Transsexualism/psychology , Gender Identity , Dissociative Identity Disorder/epidemiology , Sex Factors , Interview, Psychological/methods , Mental Disorders/epidemiologyABSTRACT
BACKGROUND AND OBJECTIVE: The aim was to study the effectiveness of the gradual nicotine withdrawal without nicotine replacement therapy (NRT) as a method of smoking cessation during a three years follow-up period in the cognitive-behavioural context in the clinical work of the Clinic Hospital Unit. PATIENTS AND METHOD: Two groups of patients with similar sociodemographic and clinical characteristics and the same degree of nicotine dependence according to the Fageströmtest were compared. We included 111 patients treated for smoking cessation in the Unit Hospital: 84 patients, under the cognitive-behavioural model, were treated with NRT and 27 patients, under the same model, were treated only with gradual nicotine withdrawal without NRT. RESULTS: There was not a significant difference between the effectiveness of the NRT (65.3%) and that of the gradual nicotine withdrawal without the NRT (51.8%) on smoking cessation(X2 =1.612; p = 0.204) at the first year or during a 3 years follow-up period (NRT: 41% and gradual nicotine withdrawal: 36%; X2: 0.124; p = 0. 725). CONCLUSIONS: The gradual nicotine withdrawal without NRT scheme shows the same degree of effectiveness at the first year and during a three years follow-up period as that of the nicotine replacement therapy scheme on smoking cessation.