Transgender health research announcements

It has been reported that new research has found that transgender patients face no higher risk of breast cancer than the general population.

Medical researcher George Brown, MD, of Mountain Home VA Medical Center in Johnson City, TN has sifted through the medical records of veterans from 1998-2013 and identified 10 cases of breast cancer in transgender people.

Brown discovered that breast cancers of people who were declared male at birth tended to be more advanced tan those of people who were declared female at birth.

Of the three birth sex males, two identified as gender dysphoric male-to-female and one identified as transgender with transvestic fetishism.

The birth sex males all presented with late-stage disease that proved fatal, whereas most of the birth sex female transgender veterans presented with earlier stage disease that could be treated.

Overall, however, transgender people appear to be at no higher odds for developing breast cancer. Speaking in a journal news release, Brown said that when groups of transgender and transsexual people are tracked over time, this has "not led to the detection of an increased incidence relative to the general population."

This report expands the known cases of breast cancer in transgender persons from 5 to 12 (female-to-male) and from 10 to 13 (male-to-female).

Breast cancer in transgender patients is rarely reported, and when it is, it is often in association with hormonal therapy and mentioned as a potential side effect of that therapy, particularly with estrogens.

--William Byne, MD, PhD, editor-in-chief, LGBT Health

Meanwhile the NIH has funded the first study in the US to investigate the long term outcomes of medical treatment for transgender youth. The NIH committed $.5.7 million for the study.

Researchers will conduct a five-year, multicenter study designed to present evidence-based information on the physiological and psychosocial impact, and the safety of hormone blockers and cross-sex hormones use in this demographic. The study will take place across four academic medical centers with transgender youth clinics.

The study will evaluate 280 transgender youth with gender dysphoria seeking medical intervention to match their physical bodies with gender identity and relieve associated negative effects (eg, anxiety, depression, substance abuse); patient enrollment will start in the fall of 2015. Two different age groups will be included: younger children in early puberty who will receive GnRH agonists to halt puberty; and older adolescents who will start taking masculinizing or feminizing cross-sex hormones to align their gender identity and puberty.

The younger aged cohort will be assessed for the impact of treatment on mental health, psychological well-being, physiologic parameters, bone health, and the safety of hormone blockers. The older aged cohort will be assessed for the safety of cross-sex hormone administration for phenotypic gender transition, impact on mental health, psychological well-being, and various metabolic/physiological parameters.

The study will be led by researchers from the Child and Adolescent Gender Center (CAGC) at UCSF Benioff Children's Hospital San Francisco, Children's Hospital Los Angeles, Ann & Robert H. Lurie Children's Hospital of Chicago, and Boston Children's Hospital.

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