Background: T-treated F2M transgender men can compete in elite sport but the impact of exogenous T on doping tests has not been not reported. We aimed to determine urine and serum steroid profiles in T-treated F2M transgender compared with hypogonadal and healthy male controls.
Method: Transgender (n=23) and hypogonadal (n=24) men treated with injectable T undecanoate (aged 18-50 years without chronic medical illness or history of drug abuse) and healthy, age-matched controls (n=20) provided a urine and blood sample at time of next T dose (trough) and an additional sample (n=21) earlier after a T dose. Steroids were measured by MS-based methods in urine (Australian Sports Drug Testing Laboratory, NMI) and serum (Andrology laboratory, ARI) and gonadotrophins by immunoassay.
Results: Urine LH, hCG, T, epitestosterone, androsterone, etiocholanolone, A/E ratio, DHEA, DHT, 5α,3α- and 5β, 3α diols did not differ between groups or according to time since last T dose. Urine T/E ratio was <4 in all controls and 12/68 (18%) samples from T-treated men, probably due to UGT2B17 deletor genotype, but without difference between T-treated groups. Serum estradiol, estrone and DHEA were higher in F2M and serum T and DHT were higher on earlier compared with trough samples, but serum LH, FSH, 3α- and 3β 5α diols did not differ between groups.
Conclusion: Urine doping detection tests in T-treated F2M can be interpreted like T-treated hypogonadal men and are unaffected by time since last T dose, unlike serum steroids.
Funded by the Partnership for Clean Competition