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Consecutive lynestrenol and cross-sex hormone treatment in biological female adolescents with gender dysphoria: a retrospective analysis

BACKGROUND: Prior to the start of cross-sex hormone therapy (CSH), androgenic progestins are often used to induce amenorrhea in female to male (FtM) pubertal adolescents with gender dysphoria (GD). The aim of this single-center study is to report changes in anthropometry, side effects, safety parameters, and hormone levels in a relatively large cohort of FtM adolescents with a diagnosis of GD at Tanner stage B4 or further, who were treated with lynestrenol (Orgametril®) monotherapy and in combination with testosterone esters (Sustanon®). METHODS: A retrospective analysis of clinical and biochemical data obtained during at least 6 months of hormonal treatment in FtM adolescents followed at our adolescent gender clinic since 2010 (n = 45) was conducted. McNemar's test to analyze reported side effects over time was performed. A paired Student's t test or a Wilcoxon signed-ranks test was performed, as appropriate, on anthropometric and biochemical data. For biochemical analyses, all statistical tests were done in comparison with baseline parameters. Patients who were using oral contraceptives (OC) at intake were excluded if a Mann-Whitney U test indicated influence of OC. RESULTS: Metrorrhagia and acne were most pronounced during the first months of monotherapy and combination therapy respectively and decreased thereafter. Headaches, hot flushes, and fatigue were the most reported side effects. Over the course of treatment, an increase in musculature, hemoglobin, hematocrit, creatinine, and liver enzymes was seen, progressively sliding into male reference ranges. Lipid metabolism shifted to an unfavorable high-density lipoprotein (HDL)/low-density lipoprotein (LDL) ratio; glucose metabolism was not affected. Sex hormone-binding globulin (SHBG), total testosterone, and estradiol levels decreased, and free testosterone slightly increased during monotherapy; total and free testosterone increased significantly during combination therapy. Gonadotropins were only fully suppressed during combination therapy. Anti-Müllerian hormone (AMH) remained stable throughout the treatment. Changes occurred in the first 6 months of treatment and remained mostly stable thereafter. CONCLUSIONS: Treatment of FtM gender dysphoric adolescents with lynestrenol monotherapy and in combination with testosterone esters is effective, safe, and inexpensive; however, suppression of gonadotropins is incomplete. Regular blood controls allow screening for unphysiological changes in safety parameters or hormonal levels and for medication abuse.

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Asexuality: a multidimensional approach

While lack of sexual attraction, lack of sexual behavior, and self-identification as asexual have been used as criteria to define asexuality, it is not known how much they overlap in describing the same group of people. This study aimed to assess how many individuals could be identified as asexual based on each of these criteria and on combinations of these criteria. Participants were recruited through the Asexuality Visibility and Education Network, social media, and posts on several health- and lifestyle-related websites. In total, 566 participants between 18 and 72 years old (M=27.86, SD=10.53) completed an online survey (24% male, 68.9% female, 7.1% other). Based on self-identification or lack of sexual attraction, 71.3% and 69.2%, respectively, of participants were categorized as asexual, while based on lack of sexual behavior only 48.5% were categorized as asexual. Gender differences were found only for those participants who indicated that they did not experience sexual attraction, with more women (72.8%) than men (58.8%) indicating a lack of sexual attraction. Given that self-identification as asexual implies familiarity with the term asexual, we argue for the use of lack of sexual attraction as the primary criterion to define asexuality.

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Host Cell Stress Responses to Flavivirus Infection

Characterizing host cell response to viral infection is a valuable step in therapeutic discovery. In light of the current Zika virus outbreak, the review published by Blázquez et al. (2014) of papers investigating these pathways following flavivirus infection is a useful refresher for researchers engaged in world health initiatives.1 Members of the Flavivirus genus are Read the rest of this article

The post Host Cell Stress Responses to Flavivirus Infection appeared first on Accelerating Science.

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Skin surgery, an evidence-based update: meeting report

Summary

The Evidence Based Update on Skin Surgery was held in Nottingham in May 2015. The meeting featured presentations on new diagnostic techniques, trials in development, discussions of recently published trials, and a question and answer session with an expert panel. This report aims to summarize the presentations and discussions from the day.

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