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Research Relating to Transgender HRT

Mutual Medical Education for a Neglected Community

While there is a plethora of research on trans people, the focus of this repository is Gender Affirming HRT (Hormone Replacement Therapy). There is a section on affirming surgical procedures that will grow with time (and hopefully your help!), but the bulk of the research posted here will focus on the use of testosterones, estrogens, antiandrogens, progestogens, and puberty blockers (GnRH agonists).

Categories & How to Use Them

The research is divided into categories, but it's important to note that it's NOT divided by transition type or gender identity, with the exception of a special category for research that mentions non-binary folks. It hasn't been divided between trans maculine and trans feminine because many of the studies involve both and much of the research relating to the effects of testosterone and estrogen applies to both groups in opposing ways. If you are trans feminine and looking for information about the effects of going on estrogen, it's strongly encouraged that you also read the research about testosterone so you are aware of what effects you'll be losing when you start antiandrogens. The inverse applies for transmasculine folks as well. Some research appears in multiple categories as applicable, and the newest posted research will appear at the top of each category.

 

Paywalls

Some of these research papers are behind paywalls, meaning they are not free to read in their enirety. Reading the abstract can often give some valuable insight, and if you are a college student or work in medicine you may be able to access the full text version without paying. Some of the sites have a link that allows you to request the full version from the author, which often works as authors want their work to be read. The creators of this site firmly believe all research papers should be free to the public, but unfortunately academia and the scientific community are drenched in accessibility and class barriers. Great effort was put into locating free, full-text versions and the only ones behind paywalls could not be located elsewhere for free. If you find a link to a free, full-text version of a paper that is listed here behind a paywall, please submit it using the Submit a Link form so others can access it.

 

Not All Research is Equal

 

There are different types of research papers, ranging from studies of a single case to systematic reviews of all literature available on a topic. Research posted here is not necessarily hard fact, or even promoted as truth by the creators of this site. In fact, you may find some of it downright offensive, especially in regard to terminology used. Some of it is contradicted by other research posted here. The information is presented as-is, without opinion, for you to use how you see fit. 
Here is a graphic that may help those who are new to research papers determine how much weight a single piece of research may have based on what type of paper it is:

study_design_v3.0.png

Ways to Use This Research

If you have concerns that are backed up by research found here, print it out and take it to your doctor or healthcare provider. They may be able to help you understand what it means and/or it may be new information for them that ends up helping you and other trans folks. 

Take it all in, and keep it in mind as you start your HRT journey. If something happens to you that you read about here, having the knowledge of why it's happening may be extremely helpful. 

 

Prepare yourself for possibilities.

 

Consider the risks before you decide what steps you want to take in your transition. There are risks and rewards for everything, and only you can decide if it's worth it in your particular case.

If you have a loved one on HRT or considering it, educate yourself on what they may be experiencing.

Share this repository with friends, family, medical professionals, etc to increase general knowledge about transgender HRT!

Read about why this repository was created

AFFIRMING SURGERY

Title
Paywall
Date published
Date Added
Risk factors for genital lichen sclerosus in men
Yes
10/1/2010
4/21/2020
Medical dermatologic conditions in transgender women
No
10/11/2018
4/21/2020
Gender-affirming hormones and surgery in transgender children and adolescents
No
6/1/2019
4/20/2020
Transwomen and the Metabolic Syndrome: Is Orchiectomy Protective?
No
8/1/2016
4/20/2020
Sexual Functioning in Transsexuals Following Hormone Therapy and Genital Surgery: A Review (CME)
No
11/01/2009
4/20/2020
Sexual and Physical Health After Sex Reassignment Surgery
No
12/1/2005
4/20/2020
Sexual Desire in Trans Persons: Associations with SexReassignment Treatment
No
1/1/2014
4/20/2020
A Prospective Study on Sexual Function and Mood in Female-to-Male Transsexuals During Testosterone Administration and After Sex Reassignment Surgery
No
3/7/2013
4/20/2020
Orgasm in the postoperative transsexual
Yes
4/1/1993
4/20/2020
Long-Term Sensitivity and Patient-Reported Functionality of the Neoclitoris After Gender Reassignment Surgery
Yes
2/1/2017
4/20/2020
Endometriosis Presenting in a Transgender Male
Yes
11/1/2017
4/20/2020
Factors Associated with Gender-Affirming Surgery and Age of Hormone Therapy Initiation Among Transgender Adults
No
10/1/2017
4/20/2020
Reduction in Mental Health Treatment Utilization Among Transgender Individuals After Gender-Affirming Surgeries: A Total Population Study
No
10/4/2019
4/20/2020
Healthcare costs and quality of life outcomes following gender affirming surgery in trans men: a review
No
10/9/2017
4/20/2020
Vaginal prolapse, pelvic floor function, and related symptoms 16 years after sex reassignment surgery in transsexuals
Yes
4/1/2011
4/20/2020
Long-Term Urogynecological Complications after Sex Reassignment Surgery in Transsexual Patients: a Retrospective Study of 44 Patients and Diagnostic Algorithm Proposal -
No
12/15/2017
4/20/2020
Transgender Phonosurgery: A Systematic Review and Meta-analysis
Yes
3/28/2017
4/20/2020
Vocal Feminization for Transgender Women: Current Strategies and Patient Perspectives
No
2/12/2020
4/20/2020
Surgical and pharmacological reassignment: influence on transsexual cardiovascular risk profile
Yes
8/1/2017
4/20/2020
Anterior Glottic Web Formation for Voice Feminization: Experience of 27 Patients
Yes
3/31/2017
4/20/2020
Uterus transplantation in and beyond cisgender women: revisiting procreative liberty in light of emerging reproductive technologies
No
7/10/2018
4/20/2020
Occurence of phantom genitalia after gender reassignment surgery
Yes
2/1/2007
4/20/2020
Phantom penises in transsexuals.
Yes
1/1/2008
4/20/2020
Phantom erectile penis after sex reassignment surgery.
Yes
1/1/2008
4/20/2020
Female-to-male transgender chest reconstruction: A large consecutive, single-surgeon experience
Yes
12/1/2011
4/20/2020
Chest Reconstruction and Chest Dysphoria in Transmasculine Minors and Young Adults
No
5/1/2018
4/20/2020
Sexual Function After Shallow and Full-Depth Vaginoplasty: Challenges, Clinical Findings, and Treatment Strategies- Urologic Perspectives
Yes
7/1/2018
4/20/2020

AGING

APPETITE & WEIGHT

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BEHAVIORAL CHANGES

BONE HEALTH

CANCER

CHRONIC ILLNESS

Title
Paywall
Date published
Date Added
Significant symptomatic improvement of subacute cutaneous lupus after testosterone therapy in a female-to-male transgender subject
Yes
10/9/2017
No
Estrogen Reverses HDAC Inhibitor-Mediated Repression of Aicda and Class-Switching in Antibody and Autoantibody Responses by Downregulation of miR-26a
No
3/24/2020
4/21/2020
Development of systemic lupus erythematosus in a male-to-female transsexual: the role of sex hormones revisited
Yes
7/29/2013
4/21/2020
New onset systemic lupus erythematosus in a transgender man: possible role of feminizing sex hormones.
Yes
1/31/2007
4/21/2020
Effects of Sex Hormone Treatment on the Metabolic Syndrome in Transgender Individuals: Focus on Metabolic Cytokines
No
12/5/2017
4/20/2020
Sympathovagal imbalance in transsexual subjects
No
11/1/2008
4/20/2020
Feminization of chronic alcoholic men: a formulation.
No
3/1/1979
4/20/2020
Caring for transgender patients with epilepsy
No
8/3/2017
4/20/2020
Kallmann's syndrome and transsexualism
Yes
2/1/2001
4/20/2020
Endometriosis Presenting in a Transgender Male
Yes
11/1/2017
4/20/2020
Pelvic pain and persistent menses in transgender men
No
6/17/2016
4/20/2020
Immune Modulation And Increased Neurotrophic Factor Production In Multiple Sclerosis Patients Treated With Testosterone
No
7/31/2008
4/20/2020
Elevated Testosterone is Associated with Decreased Likelihood of Current Asthma Regardless of Gender
No
2/1/2019
4/20/2020
The role of testosterone in MS risk and course
No
1/8/2018
4/20/2020
Do low testosterone levels contribute to the pathogenesis of asthma?
No
6/26/2010
4/20/2020
Gender-Related Effects of Sex Steroids on Histamine Release and FcεRI Expression in Rat Peritoneal Mast Cells
No
4/20/2015
4/20/2020
Human mast cells express androgen receptors but treatment with testosterone exerts no influence on IgE‐independent mast cell degranulation elicited by neuromuscular blocking agents
No
2/11/2010
4/20/2020
Testosterone exerts selective anti‐inflammatory effects on human skin mast cells in a cell subset dependent manner
No
8/14/2012
4/20/2020
Female Sex Hormones Pattern and Its Relation to Disease Severity and Treatment in Pre- and Postmenopausal Patients with Chronic Hepatitis C Virus (Genotype 4) Infection
No
8/17/2015
4/20/2020
Novel associations between sex hormones and diabetic vascular complications in men and postmenopausal women: a cross-sectional study
No
7/31/2019
4/20/2020
Sex hormones and their influence on chronic kidney disease
No
1/1/2019
4/20/2020
Treatment of pain in fibromyalgia patients with testosterone gel: Pharmacokinetics and clinical response
No
8/1/2015
4/20/2020
Daily fluctuations of progesterone and testosterone are associated with fibromyalgia pain severity
No
12/14/2017
4/20/2020
ffects of gender-affirming hormone therapy on insulin resistance and body composition in transgender individuals: A systematic review
No
3/15/2020
4/20/2020
Development of systemic sclerosis in transgender females: a case series and review of the literature
No
2/19/2018
4/20/2020

COGNITIVE CHANGES

DYSPHORIA

FERTILITY

GENERAL

Title
Paywall
Date published
Date Added
Medical management of transgender children and adolescents
No
12/7/2018
4/20/2020
Factors Associated with Gender-Affirming Surgery and Age of Hormone Therapy Initiation Among Transgender Adults
No
10/1/2017
4/20/2020
Clinical pearls of gender-affirming hormone therapy in transgender patients
No
3/26/2018
4/20/2020
Comparing the health of non-binary and binary transgender adults in a statewide non-probability sample
No
8/27/2019
4/20/2020
Health of Non-binary and Genderqueer People: A Systematic Review
No
6/25/2019
4/20/2020
Genders and Individual Treatment Progress in (Non-)Binary Trans Individuals
No
1/1/2018
4/20/2020
How Gender Identity and Treatment Progress Impact Decision-Making, Psychotherapy and Aftercare Desires of Trans Persons
No
5/26/2019
4/20/2020
Research Priorities for Gender Nonconforming/Transgender Youth: Gender Identity Development and Biopsychosocial Outcomes
No
4/1/2017
4/20/2020
A review of the physical and metabolic effects of cross-sex hormonal therapy in the treatment of gender dysphoria
No
5/1/2015
4/20/2020
Adult Development and Quality of Life of Transgender and Gender Nonconforming People
No
4/1/2017
4/20/2020
A Cross-Sectional Multicenter Study of Multidimensional Body Image in Adolescents and Adults with Gender Dysphoria Before and After Transition-Related Medical Interventions
No
8/7/2018
4/20/2020
Endocrinology of Transgender Medicine
No
10/10/2018
4/20/2020
Endocrine care of transpeople Part I. a review of cross-sex hormonal treatments, outcomes and adverse effects in transmen
Yes
2/1/2015
4/20/2020
Endocrine care of transpeople part II. A review of cross‐sex hormonal treatments, outcomes and adverse effects in transwomen
yes
2/18/2015
4/20/2020
ESTROGEN LEVELS DO NOT RISE WITH TESTOSTERONE TREATMENT FOR TRANSGENDER MEN
yes
3/20/2018
4/20/2020
PROLACTIN LEVELS DO NOT RISE AMONG TRANSGENDER WOMEN TREATED WITH ESTRADIOL AND SPIRONOLACTONE
yes
4/30/2018
4/20/2020
Increase in insuline-like growh factor levels during cross-sex hormone treatment in transgender persons
Yes
5/1/2016
4/20/2020
Testosterone undecanoate and testosterone enanthate injections are both effective and safe in transmen over 5 years of administration.
Yes
8/12/2018
4/20/2020
Long-Term Administration of Testosterone Undecanoate Every 3 Months for Testosterone Supplementation in Female-to-Male Transsexuals
No
9/1/2007
4/20/2020
(Patho)physiology of cross-sex hormone administration to transsexual people: The potential impact of male-female genetic differences
Yes
12/1/2014
4/20/2020
Brain Sex Differences Related to Gender Identity Development: Genes or Hormones?
No
3/19/2020
4/20/2020
Testosterone Effects on the Brain in Transgender Men.
No
5/1/2018
4/20/2020

GYNECOLOGICAL

Title
Paywall
Date published
Date Added
Serum Levels of Sex Hormones in Vulvar Lichen Sclerosus, and the Effect of Topical Testosterone
Yes
2/23/1984
4/21/2020
OR11-3 Evidence for Preserved Ovarian Reserve in Transgender Men Receiving Testosterone Therapy: Anti-Mullerian Hormone Serum Levels Decrease Modestly after One Year of Treatment
Yes
4/30/2019
4/20/2020
Gynaecological aspects of the treatment and follow-up of transsexual men and women
No
3/1/2010
4/20/2020
Endometriosis Presenting in a Transgender Male
Yes
11/1/2017
4/20/2020
Impact of Exogenous Testosterone on Reproduction in Transgender Men
Yes
3/1/2020
4/20/2020
Uterine and ovarian changes during testosterone administration in young female-to-male transsexuals
No
10/1/2016
4/20/2020
Contraception Care for Transmasculine Individuals on Testosterone Therapy
yes
4/17/2019
4/20/2020
Contraception Across the Transmasculine Spectrum
No
8/1/2019
4/20/2020
Effects of long-term high dose testosterone administration on vaginal epithelium structure and estrogen receptor-α and -β expression of young women
No
4/4/2013
4/20/2020
Effect of Long-Term Testosterone Administration on the Endometrium of Female-to-Male (FtM) Transsexuals
Yes
7/1/2009
4/20/2020
Induction and Maintenance of Amenorrhea in Transmasculine and Nonbinary Adolescents
no
11/1/2017
4/20/2020
Pelvic pain and persistent menses in transgender men
No
6/17/2016
4/20/2020
Exogenous testosterone does not induce or exacerbate the metabolic features associated with pcos among transgender men
Yes
4/1/2018
4/20/2020
Uterine pathology in transmasculine persons on testosterone: a retrospective multicenter case series
No
3/1/2019
4/20/2020

HAIR & SKIN

Title
Paywall
Date published
Date Added
Androgens and hair growth
Yes
9/1/2008
No
Significant symptomatic improvement of subacute cutaneous lupus after testosterone therapy in a female-to-male transgender subject
Yes
10/9/2017
No
A randomized, double-blind, placebo-controlled study on the effect of conjugated estrogens on skin thickness.
Yes
2/1/1994
4/21/2020
Antiandrogen therapy for skin and hair disease.
Yes
4/1/2006
4/21/2020
Serum Levels of Sex Hormones in Vulvar Lichen Sclerosus, and the Effect of Topical Testosterone
Yes
2/23/1984
4/21/2020
Estrogens and the hair follicle.
Yes
6/1/2004
4/21/2020
Development of systemic lupus erythematosus in a male-to-female transsexual: the role of sex hormones revisited
Yes
7/29/2013
4/21/2020
Risk factors for genital lichen sclerosus in men
Yes
10/1/2010
4/21/2020
Hair regrowth in a male patient with extensive androgenetic alopecia on estrogen therapy
Yes
9/1/2012
4/21/2020
Medical dermatologic conditions in transgender women
No
10/11/2018
4/21/2020
New onset systemic lupus erythematosus in a transgender man: possible role of feminizing sex hormones.
Yes
1/31/2007
4/21/2020
Risk factors for acne development in the first 2 years after initiating masculinizing testosterone therapy among transgender men
No
8/1/2019
4/21/2020
Short- and Long-Term Clinical Skin Effects of Testosterone Treatment in Trans Men
No
10/31/2013
4/21/2020
Estrogens and aging skin
No
4/1/2013
4/21/2020
Scalp Hair Regrowth in Hormone-Treated Transgender Woman
No
10/1/2016
4/21/2020
Effects of Sex Steroid Deprivation/Administration on Hair Growth and Skin Sebum Production in Transsexual Males and Females
no
8/1/2000
4/20/2020
Severe Acne in Female-to-Male Transgender Patients
no
11/1/2015
4/20/2020
Dermatologic Conditions in Transgender Populations
Yes
6/1/2019
4/20/2020

HEART HEALTH

LONG TERM

MENTAL HEALTH

Title
Paywall
Date published
Date Added
Pubertal Suppression for Transgender Youth and Risk of Suicidal Ideation
No
2/1/2020
4/20/2020
A Role for Estrogen in Schizophrenia: Clinical and Preclinical Findings
No
9/27/2015
4/20/2020
Progesterone: The neglected hormone in schizophrenia? A focus on progesterone-dopamine interactions.
No
8/24/2016
4/20/2020
Estradiol reverses excitatory synapse loss in a cellular model of neuropsychiatric disorders
No
1/21/2020
4/20/2020
Sex differences in schizophrenia, bipolar disorder, and post-traumatic stress disorder: Are gonadal hormones the link?
No
3/14/2019
4/20/2020
Aggression: The Testosterone-Serotonin Link
No
9/1/2003
4/20/2020
Correlates of suicide ideation and behaviors among transgender people: A systematic review guided by ideation-to-action theory
No
6/21/2018
4/20/2020
Hormone-treated transsexuals report less social distress, anxiety and depression
No
8/23/2011
4/20/2020
A Systematic Review of the Effects of Hormone Therapy on Psychological Functioning and Quality of Life in Transgender Individuals
No
1/1/2016
4/20/2020
High-Dose Testosterone Treatment Increases Serotonin Transporter Binding in Transgender People
No
9/1/2014
4/20/2020
Testosterone levels in suicide attempters with bipolar disorder
No
10/29/2013
4/20/2020
Sex hormones play a role in vulnerability to sleep loss on emotion processing tasks
No
10/12/2017
4/20/2020
Testosterone as a biological marker in psychopathy and alcoholism
No
11/21/1997
4/20/2020
Gender-Affirming Hormone Use in Transgender Individuals: Impact on Behavioral Health and Cognition
No
10/11/2018
4/20/2020
Cognitive Impacts of Estrogen Treatment in Androgen-Deprived Males: What Needs to be Resolved
No
3/1/2017
4/20/2020
How Gender Identity and Treatment Progress Impact Decision-Making, Psychotherapy and Aftercare Desires of Trans Persons
No
5/26/2019
4/20/2020

NON-BINARY

PAIN

PHYSICAL CHANGES

SEX

SLEEP

SUBSTANCE USE/ABUSE

Title
Paywall
Date published
Date Added
Females Are More Vulnerable to Drug Abuse than Males: Evidence from Preclinical Studies and the Role of Ovarian Hormones
Yes
1/1/2011
4/26/2020
Ovarian hormones and propensity to drug relapse: A review
Yes
1/1/2011
4/26/2020
Sex differences in the vulnerability to drug abuse: a review of preclinical studies
Yes
10/1/2004
4/26/2020
Sex Differences in Drug Addiction: A Review of Animal and Human Studies
No
1/1/2008
4/26/2020
Biological basis of sex differences in drug abuse: preclinical and clinical studies
No
9/5/2002
4/26/2020
Ovarian Hormones and Drug Abuse
No
11/1/2014
4/26/2020
Sex hormones in alcohol consumption: a systematic review of evidence
No
12/27/2017
4/20/2020
The Relationship Between Tobacco Use and Legal Document Gender-Marker Change, Hormone Use, and Gender-Affirming Surgery in a United States Sample of Trans-Feminine and Trans-Masculine Individuals: Implications for Cardiovascular Health
No
10/1/2018
4/20/2020
Testosterone as a biological marker in psychopathy and alcoholism
No
11/21/1997
4/20/2020
The role of testosterone in the development of experimental alcoholism
No
1/1/1980
4/20/2020
CONTROLLED STUDY ON THE COMBINED EFFECT OF ALCOHOL AND TOBACCO SMOKING ON TESTOSTERONE IN ALCOHOL-DEPENDENT MEN
No
10/17/2006
4/20/2020
Feminization of chronic alcoholic men: a formulation.
No
3/1/1979
4/20/2020
Correlations between sex-related hormones, alcohol dependence and alcohol craving.
No
4/1/2019
4/20/2020
Association of testosterone and BDNF serum levels with craving during alcohol withdrawal
No
8/1/2016
4/20/2020

YOUTH