Background: Management of gender dysphoria is gaining increasing recognition but most research focuses on male to female transgender with less information on clinical features of FTM transgender. We aim to report the characteristics of FTM transgender presenting over two decades to one tertiary academic centre.
Method: Review of 100 FTM transgender presenting to the Andrology Department, Concord Hospital between 1994 and 2014. Data presented as mean±SEM or %.
Results: Mean age 30 ± 1 (18–64) yr with 3 presenting post-menopause and 22 having initiated testosterone treatment elsewhere. At presentation, 53% were employed, 33% current smokers, 58% consumed alcohol and 5% currently used recreational drugs. Co-morbidities included overweight (BMI >25, 33%) with morbid obesity (BMI>35) in 8 (24%), 40% had pre-existing mental illness with 22 (55%) using psychotropic drugs.
Surgical history recorded throughout study period included 53% with bilateral mastectomy and 24% with hysterectomy/oophorectomy but only two had gender affirming surgery (phalloplasty, metoidioplasty, 1 each). Most surgery was performed after initiation of testosterone, apart from 3 who had hysterectomy/oophorectomy pre-transition for gynaecological reasons. Most were treated with injectable testosterone undecanoate (72%) or else shorter acting injectable testosterone esters (23%) or transdermal testosterone (2%). At presentation, serum testosterone was 1.8±0.3 nmol/L in previously untreated and 18.5±2.5 nmol/L in pre-treated and serum testosterone at latest follow-up was 20.4±1.3 nmol/L. Similarly, mean haemoglobin was 136±1 g/L in previously untreated and 152 ±3 g/L in pre-treated patients, which increased to 159±1 g/L at latest follow up.
Conclusion: This study provides an overview of the clinical features of FTM transgender and their comorbidities. Further analysis will provide more insight into this understudied but growing population with a focus on optimizing long-term medical management.