RT Journal Article
SR Electronic
T1 Erythrocytosis in Gender-Affirming Care With Testosterone
JF The Annals of Family Medicine
JO Ann Fam Med
FD American Academy of Family Physicians
SP 403
OP 407
DO 10.1370/afm.3018
VO 21
IS 5
A1 Porat, Alana Tova
A1 Ellwood, Meghan
A1 Rodina, Marisa
A1 Dianat, Shokoufeh
YR 2023
UL http://www.annfammed.org/content/21/5/403.abstract
AB PURPOSE Gender-affirming hormone therapy (GAHT) is safe overall, with few adverse effects. One potential effect from using testosterone for GAHT is an increase in hemoglobin and/or hematocrit, known as secondary erythrocytosis. Current guidelines recommend monitoring hemoglobin or hematocrit routinely in the first year, some as frequently as every 3 months, which can create barriers to care. Our study explored the incidence of erythrocytosis in the first 20 months of testosterone therapy among people receiving gender-affirming care.METHODS This is a descriptive fixed cohort study of hematocrit and hemoglobin data from the charts of 282 people taking testosterone for GAHT.RESULTS During the first 20 months of testosterone therapy, the cumulative incidence of hematocrit >50.4% was 12.6%, hematocrit >52% was 1.0%, and hematocrit >54% was 0.6%. All people were taking injectable testosterone cypionate, with a median dose of 100 mg weekly.CONCLUSION Severe erythrocytosis (hematocrit >54%) is a rare outcome of gender-affirming testosterone therapy. Clinical recommendations should reconsider the need for routine frequent erythrocytosis screening within the first year of testosterone therapy for patients who prefer to minimize laboratory draws.