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Research ArticleCurrent Issues in Laboratory Medicine

Impact of Hormone Therapy on Laboratory Values in Transgender Patients

Jeffrey A. SoRelle, Rhoda Jiao, Emily Gao, Jonas Veazey, Ithiel Frame, Andrew M. Quinn, Philip Day, Patti Pagels, Nora Gimpel, Khushbu Patel
DOI: 10.1373/clinchem.2018.292730 Published December 2018
Jeffrey A. SoRelle
Department of Pathology, UT Southwestern Medical Center, Dallas, TX.
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  • For correspondence: khushbu.patel@utsouthwestern.edujeff.sorelle@gmail.com
Rhoda Jiao
Department of Pathology, UT Southwestern Medical Center, Dallas, TX.
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Emily Gao
Department of Pathology, UT Southwestern Medical Center, Dallas, TX.
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Jonas Veazey
Department of Pathology, UT Southwestern Medical Center, Dallas, TX.
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Ithiel Frame
Department of Pathology, UT Southwestern Medical Center, Dallas, TX.
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Andrew M. Quinn
Department of Pathology, UT Southwestern Medical Center, Dallas, TX.
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Philip Day
Department of Pathology, UT Southwestern Medical Center, Dallas, TX.
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Patti Pagels
Department of Pathology, UT Southwestern Medical Center, Dallas, TX.
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Nora Gimpel
Department of Pathology, UT Southwestern Medical Center, Dallas, TX.
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Khushbu Patel
Department of Pathology, UT Southwestern Medical Center, Dallas, TX.
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  • For correspondence: khushbu.patel@utsouthwestern.edujeff.sorelle@gmail.com
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Abstract

Background: For transgender individuals taking hormone therapy (HT), data on laboratory values are limited, and the effects on laboratory values cannot be easily predicted. We evaluated the impact on common laboratory analytes in transgender individuals before and after initiation of HT.

Methods: We conducted a retrospective chart review of transgender patients identified at transgender-specific clinics at an urban county hospital and community clinic. Laboratory data were collected on hormone concentrations, hematologic parameters, electrolytes, lipids, and liver and renal markers before and after initiation of HT.

Results: We identified 183 transgender women (TW) and 119 transgender men (TM) for whom laboratory data were available. In all, 87 TW and 62 TM had baseline laboratory data, and data were also available for 133 TW and 89 TM on HT for >6 months. The most significant changes were seen in red blood cell count, hemoglobin concentration, hematocrit, and creatinine levels after >6 months of HT, which increased in TM and decreased in TW after HT (P < 0.005; d index > 0.6). Alkaline phosphatase, aspartate aminotransferase, and alanine aminotransferase levels increased in TM; however, the effect size was small (d index < 0.5). Calcium, albumin, and alkaline phosphatase levels significantly decreased in TW (P < 0.001; d > 0.6). Additionally, TM were found to have increased triglycerides and decreased HDL levels (P < 0.005; d > 0.6).

Conclusions: Changes occur in several common laboratory parameters for patients on HT. Some laboratory values changed to match the gender identity, whereas others remained unchanged or were intermediate from the baseline values. These findings will help guide interpretation of laboratory test results in transgender patients taking HT.

  • Received for publication June 12, 2018.
  • Accepted for publication November 7, 2018.
  • © 2018 American Association for Clinical Chemistry

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Clinical Chemistry: 65 (2)
Vol. 65, Issue 2
February 2019
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Impact of Hormone Therapy on Laboratory Values in Transgender Patients
Jeffrey A. SoRelle, Rhoda Jiao, Emily Gao, Jonas Veazey, Ithiel Frame, Andrew M. Quinn, Philip Day, Patti Pagels, Nora Gimpel, Khushbu Patel
Clinical Chemistry Jan 2018, clinchem.2018.292730; DOI: 10.1373/clinchem.2018.292730
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Impact of Hormone Therapy on Laboratory Values in Transgender Patients
Jeffrey A. SoRelle, Rhoda Jiao, Emily Gao, Jonas Veazey, Ithiel Frame, Andrew M. Quinn, Philip Day, Patti Pagels, Nora Gimpel, Khushbu Patel
Clinical Chemistry Jan 2018, clinchem.2018.292730; DOI: 10.1373/clinchem.2018.292730

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