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[automated] update transfemscience
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<?xml version="1.0" encoding="utf-8"?><feed xmlns="http://www.w3.org/2005/Atom" ><generator uri="https://jekyllrb.com/" version="3.9.5">Jekyll</generator><link href="https://transfemscience.org/feed-posts.xml" rel="self" type="application/atom+xml" /><link href="https://transfemscience.org/" rel="alternate" type="text/html" /><updated>2024-02-18T00:39:56-08:00</updated><id>https://transfemscience.org/feed-posts.xml</id><title type="html">Transfeminine Science</title><subtitle>Transfeminine Science is a site for information on hormone therapy for transfeminine people.</subtitle><author><name>Transfeminine Science</name></author></feed>
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<?xml version="1.0" encoding="utf-8"?><feed xmlns="http://www.w3.org/2005/Atom" ><generator uri="https://jekyllrb.com/" version="3.9.5">Jekyll</generator><link href="https://transfemscience.org/feed-posts.xml" rel="self" type="application/atom+xml" /><link href="https://transfemscience.org/" rel="alternate" type="text/html" /><updated>2024-03-21T19:23:45-07:00</updated><id>https://transfemscience.org/feed-posts.xml</id><title type="html">Transfeminine Science</title><subtitle>Transfeminine Science is a site for information on hormone therapy for transfeminine people.</subtitle><author><name>Transfeminine Science</name></author></feed>
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<?xml version="1.0" encoding="utf-8"?><feed xmlns="http://www.w3.org/2005/Atom" ><generator uri="https://jekyllrb.com/" version="3.9.5">Jekyll</generator><link href="https://transfemscience.org/feed.xml" rel="self" type="application/atom+xml" /><link href="https://transfemscience.org/" rel="alternate" type="text/html" /><updated>2024-02-18T00:39:56-08:00</updated><id>https://transfemscience.org/feed.xml</id><title type="html">Transfeminine Science | Articles</title><subtitle>Transfeminine Science is a site for information on hormone therapy for transfeminine people.</subtitle><author><name>Transfeminine Science</name></author><entry><title type="html">Puberty Blockers: A Review of GnRH Analogues in Transgender Youth</title><link href="https://transfemscience.org/articles/puberty-blockers/" rel="alternate" type="text/html" title="Puberty Blockers: A Review of GnRH Analogues in Transgender Youth" /><published>2022-01-30T15:04:00-08:00</published><updated>2022-01-31T00:00:00-08:00</updated><id>https://transfemscience.org/articles/puberty-blockers</id><content type="html" xml:base="https://transfemscience.org/articles/puberty-blockers/"><![CDATA[<h1 id="puberty-blockers-a-review-of-gnrh-analogues-in-transgender-youth">Puberty Blockers: A Review of GnRH Analogues in Transgender Youth</h1>
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<?xml version="1.0" encoding="utf-8"?><feed xmlns="http://www.w3.org/2005/Atom" ><generator uri="https://jekyllrb.com/" version="3.9.5">Jekyll</generator><link href="https://transfemscience.org/feed.xml" rel="self" type="application/atom+xml" /><link href="https://transfemscience.org/" rel="alternate" type="text/html" /><updated>2024-03-21T19:23:45-07:00</updated><id>https://transfemscience.org/feed.xml</id><title type="html">Transfeminine Science | Articles</title><subtitle>Transfeminine Science is a site for information on hormone therapy for transfeminine people.</subtitle><author><name>Transfeminine Science</name></author><entry><title type="html">Puberty Blockers: A Review of GnRH Analogues in Transgender Youth</title><link href="https://transfemscience.org/articles/puberty-blockers/" rel="alternate" type="text/html" title="Puberty Blockers: A Review of GnRH Analogues in Transgender Youth" /><published>2022-01-30T15:04:00-08:00</published><updated>2022-01-31T00:00:00-08:00</updated><id>https://transfemscience.org/articles/puberty-blockers</id><content type="html" xml:base="https://transfemscience.org/articles/puberty-blockers/"><![CDATA[<h1 id="puberty-blockers-a-review-of-gnrh-analogues-in-transgender-youth">Puberty Blockers: A Review of GnRH Analogues in Transgender Youth</h1>
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<ul>
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<li>Abbott Laboratories. (2009). <em>Estradiol. Architect System.</em> Abbott Park, Illinois/Wiesbaden, Germany: Abbott Laboratories. [<a href="https://web.archive.org/web/20200127014925/http://www.ilexmedical.com/files/PDF/Estradiol_ARC.pdf">PDF</a>]</li>
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<li>Behre, H. M., Abshagen, K., Oettel, M., Hubler, D., & Nieschlag, E. (1999). Intramuscular injection of testosterone undecanoate for the treatment of male hypogonadism: phase I studies. <em>European Journal of Endocrinology</em>, <em>140</em>(5), 414–419. [DOI:<a href="https://doi.org/10.1530/eje.0.1400414">10.1530/eje.0.1400414</a>]</li>
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</ul>]]></content><author><name>{"first_name"=>"Aly", "last_name"=>"W.", "author-link"=>"/about/#aly", "articles-link"=>"/articles-by-author/aly/"}</name></author><category term="github" /><category term="workspace" /><summary type="html"><![CDATA[An Interactive Web Simulator for Estradiol Levels with Injectable Estradiol Esters By Aly | First published July 16, 2021 | Last modified April 12, 2023]]></summary><media:thumbnail xmlns:media="http://search.yahoo.com/mrss/" url="https://transfemscience.org/assets/images/injectable-e2/simulator-screenie.png" /><media:content medium="image" url="https://transfemscience.org/assets/images/injectable-e2/simulator-screenie.png" xmlns:media="http://search.yahoo.com/mrss/" /></entry><entry><title type="html">An Informal Meta-Analysis of Estradiol Curves with Injectable Estradiol Preparations</title><link href="https://transfemscience.org/articles/injectable-e2-meta-analysis/" rel="alternate" type="text/html" title="An Informal Meta-Analysis of Estradiol Curves with Injectable Estradiol Preparations" /><published>2021-07-16T12:00:00-07:00</published><updated>2023-06-23T00:00:00-07:00</updated><id>https://transfemscience.org/articles/injectable-e2-meta-analysis</id><content type="html" xml:base="https://transfemscience.org/articles/injectable-e2-meta-analysis/"><![CDATA[<h1 id="an-informal-meta-analysis-of-estradiol-curves-with-injectable-estradiol-preparations">An Informal Meta-Analysis of Estradiol Curves with Injectable Estradiol Preparations</h1>
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</ul>]]></content><author><name>{"first_name"=>"Aly", "last_name"=>"W.", "author-link"=>"/about/#aly", "articles-link"=>"/articles-by-author/aly/"}</name></author><category term="github" /><category term="workspace" /><summary type="html"><![CDATA[An Interactive Web Simulator for Estradiol Levels with Injectable Estradiol Esters By Aly | First published July 16, 2021 | Last modified April 12, 2023]]></summary><media:thumbnail xmlns:media="http://search.yahoo.com/mrss/" url="https://transfemscience.org/assets/images/injectable-e2/simulator-screenie.png" /><media:content medium="image" url="https://transfemscience.org/assets/images/injectable-e2/simulator-screenie.png" xmlns:media="http://search.yahoo.com/mrss/" /></entry><entry><title type="html">An Informal Meta-Analysis of Estradiol Curves with Injectable Estradiol Preparations</title><link href="https://transfemscience.org/articles/injectable-e2-meta-analysis/" rel="alternate" type="text/html" title="An Informal Meta-Analysis of Estradiol Curves with Injectable Estradiol Preparations" /><published>2021-07-16T12:00:00-07:00</published><updated>2024-03-18T00:00:00-07:00</updated><id>https://transfemscience.org/articles/injectable-e2-meta-analysis</id><content type="html" xml:base="https://transfemscience.org/articles/injectable-e2-meta-analysis/"><![CDATA[<h1 id="an-informal-meta-analysis-of-estradiol-curves-with-injectable-estradiol-preparations">An Informal Meta-Analysis of Estradiol Curves with Injectable Estradiol Preparations</h1>
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<p>By
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<!-- First author --><a href="/about/#aly">Aly</a><!-- Second author --><!-- Third author --><!-- Fourth author --> | First published July 16, 2021
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| Last modified June 23, 2023</p>
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| Last modified March 18, 2024</p>
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<h2 id="abstract--tldr">Abstract / TL;DR</h2>
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<h3 id="update-3-herndon-et-al-2023">Update 3: Herndon et al. (2023)</h3>
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<p>In March 2023, the following paper on injectable estradiol in transfeminine people was published online:</p>
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<p>In March 2023, the following study on injectable estradiol in transfeminine people was published online:</p>
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<ul>
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<li>Herndon, J. S., Maheshwari, A. K., Nippoldt, T. B., Carlson, S. J., Davidge-Pitts, C. J., & Chang, A. Y. (2023). Comparison of Subcutaneous and Intramuscular Estradiol Regimens as part of Gender-Affirming Hormone Therapy. <em>Endocrine Practice</em>, <em>29</em>(5), 356–361. [DOI:<a href="https://doi.org/10.1016/j.eprac.2023.02.006">10.1016/j.eprac.2023.02.006</a>] [<a href="https://www.sciencedirect.com/science/article/abs/pii/S1530891X23000502">URL</a>]</li>
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<p>The findings of Herndon et al. (2023) are pleasingly consistent with the results of the present meta-analysis. Based on the findings of this meta-analysis, assuming a linear relationship between dose and estradiol levels, estradiol levels with non-polymeric injectable estradiol esters, like estradiol valerate and estradiol cypionate in oil via intramuscular injection, increase by around 60 pg/mL on average for each 1 mg per week in dose (with Herndon et al. (2023) finding a value of 57 pg/mL per 1 mg using a multiple linear regression model). In relation to this, mean integrated estradiol levels of around 250 pg/mL on average would be expected at a dosage of 4 mg once per week. Accordingly, Herndon et al. (2023) found median estradiol levels of 190 to 196 pg/mL at per-week median doses of 3.75 to 4 mg. Similarly, the present work recommended injectable estradiol doses with non-polymeric esters of 1 to 6 mg per week (to achieve mean integrated estradiol levels of roughly 50–300 pg/mL), which is comparable to the range of about 2 to 6 mg per week used in most transfeminine people in Herndon et al. (2023) (to achieve estradiol levels of at least 100 pg/mL, along with adequate testosterone suppression). Additionally, it was noted in this meta-analysis—based on clinical research in cisgender men with prostate cancer—that only modestly supraphysiological estradiol levels, of no more than approximately 200 to 300 pg/mL, are likely to be needed for strong testosterone suppression in transfeminine people. This has likewise been confirmed with solid clinical data in transfeminine people by Herndon et al. (2023), with 88% of those on injectable estradiol monotherapy having testosterone levels of <50 ng/dL at a median injectable estradiol dose of 4 mg/week and with median estradiol levels of 220 pg/mL. It is the opinion of the present author that Herndon et al. (2023) is a very important and formative study, with clinical implications that go far beyond merely supporting the s.c. use of injectable estradiol. The study represents the first major step in the published literature to correcting the dosing and intervals of injectable estradiol in transgender care guidelines and in transgender health generally. I commend the researchers for their work.</p>
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<h3 id="update-4-rothman-et-al-2024">Update 4: Rothman et al. (2024)</h3>
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<p>In February 2024, the following review on injectable estradiol in transfeminine people was published online:</p>
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<ul>
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<li>Rothman, M. S., Hamnvik, O. P. R., Davidge-Pitts, C., Safer, J. D., Ariel, D., Tangpricha, V., Abramowitz, J., Soe, K., Sarvaideo, J., Kelley, C., Irwig, M. S., & Iwamoto, S. J. (2024). Revisiting Injectable Estrogen Dosing Recommendations for Gender-Affirming Hormone Therapy. <em>Transgender Health</em>, ahead of print. [DOI:<a href="https://doi.org/10.1089/trgh.2023.0209">10.1089/trgh.2023.0209</a>]</li>
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</ul>
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<p>Here is the abstract of the paper:</p>
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<blockquote>
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<p>Injectable estrogens are options for gender-affirming hormone therapy per guidelines, which suggest intramuscular dosages of 5–30 mg every 2 weeks or 2–10 mg weekly with estradiol cypionate or valerate interchangeably. Data among transgender and gender-diverse patients are limited due to local unavailability and concerns around laboratory assay variability and estradiol (E2) level fluctuation. We note a concerning trend where patients are prescribed high-dose injections based on the guidelines leading to serum E2 levels well above the range recommended in the same guidelines. Our review indicates that 5 mg weekly or lower should be prescribed when initiating injectable estrogens to avoid supraphysiologic E2 levels.</p>
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</blockquote>
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<h2 id="supplementary-material">Supplementary Material</h2>
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<ul>
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<li>Reimann, I. W., Britzelmeier, C., Haber, P., Wollmann, H., Antonin, K. H., & Bieck, P. R. (1987). Influence of Oestradiol on Alpha<sub>2</sub>-Adrenoceptor Binding Sites on Intact Platelets of Young Male Volunteers. <em>European Journal of Clinical Pharmacology</em>, <em>33</em>(2), 147–150. [DOI:<a href="https://doi.org/10.1007/BF00544558">10.1007/BF00544558</a>]</li>
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<li>Rosenfield, R. L., Fang, V. S., Dupon, C., Kim, M. H., & Refetoff, S. (1973). The effects of low doses of depot estradiol and testosterone in teenagers with ovarian failure and Turner’s syndrome. <em>The Journal of Clinical Endocrinology and Metabolism</em>, <em>37</em>(4), 574–580. [DOI:<a href="https://doi.org/10.1210/jcem-37-4-574">10.1210/jcem-37-4-574</a>]</li>
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<li>Rosenfield, R. L., & Fang, V. S. (1974). The effects of prolonged physiologic estradiol therapy on the maturation of hypogonadal teen-agers. <em>The Journal of Pediatrics</em>, <em>85</em>(6), 830–837. [DOI:<a href="https://doi.org/10.1016/S0022-3476(74)80355-0">10.1016/S0022-3476(74)80355-0</a>]</li>
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<li>Rothman, M. S., Hamnvik, O. P. R., Davidge-Pitts, C., Safer, J. D., Ariel, D., Tangpricha, V., Abramowitz, J., Soe, K., Sarvaideo, J., Kelley, C., Irwig, M. S., & Iwamoto, S. J. (2024). Revisiting Injectable Estrogen Dosing Recommendations for Gender-Affirming Hormone Therapy. <em>Transgender Health</em>, ahead of print. [DOI:<a href="https://doi.org/10.1089/trgh.2023.0209">10.1089/trgh.2023.0209</a>]</li>
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<li>Sang, G. W., Ge, J. L., Liu, X. H., Shao, Q. X., Zhao, X. J., & Mao, S. M. (1987). 不同剂量庚炔诺酮单独或配伍戊酸雌二醇后的药代动力学及药效学. [Pharmacokinetics and pharmacodynamics of different doses of norethisterone enanthate alone and in combination with estradiol valerate.] <em>中国 临 床药理 学杂志</em> / <em>Chinese Journal of Clinical Pharmacology</em>, <em>3</em>(1), 7–18. [<a href="https://scholar.google.com/scholar?cluster=15044252211866156137">Google Scholar</a>] [<a href="https://kns.cnki.net/kcms/detail/detail.aspx?dbcode=CJFD&dbname=CJFD8589&filename=GLYZ198701001">CNKI</a>] [DOI:<a href="https://doi.org/10.13699/j.cnki.1001-6821.1987.01.002">10.13699/j.cnki.1001-6821.1987.01.002</a>] [<a href="https://files.transfemscience.org/pdfs/Sang%20et%20al.%20(1987)%20-%20[Pharmacokinetics%20and%20Pharmacodynamics%20of%20Different%20Doses%20of%20Norethisterone%20Enanthate%20Alone%20and%20in%20Combination%20with%20Estradiol%20Valerate].pdf">PDF</a>]</li>
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<li>Sang, G. W. (1994). Pharmacodynamic effects of once-a-month combined injectable contraceptives. <em>Contraception</em>, <em>49</em>(4), 361–385. [DOI:<a href="https://doi.org/10.1016/0010-7824(94)90033-7">10.1016/0010-7824(94)90033-7</a>]</li>
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<li>Schiavon, R., Benavides, S., Oropeza, G., Garza-Flores, J., Recio, R., Díaz-Sanchez, V., & Pérez-Palacios, G. (1988). Serum estrogens and ovulation return in chronic users of a once-a-month injectable contraceptive. <em>Contraception</em>, <em>37</em>(6), 591–598. [DOI:<a href="https://doi.org/10.1016/0010-7824(88)90005-4">10.1016/0010-7824(88)90005-4</a>]</li>
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<li>Yáñez, J. A., Remsberg, C. M., Sayre, C. L., Forrest, M. L., & Davies, N. M. (2011). Flip-flop pharmacokinetics–delivering a reversal of disposition: challenges and opportunities during drug development. <em>Therapeutic Delivery</em>, <em>2</em>(5), 643–672. [DOI:<a href="https://doi.org/10.4155/tde.11.19">10.4155/tde.11.19</a>]</li>
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<li>Zhang, Y., Huo, M., Zhou, J., & Xie, S. (2010). PKSolver: An add-in program for pharmacokinetic and pharmacodynamic data analysis in Microsoft Excel. <em>Computer Methods and Programs in Biomedicine</em>, <em>99</em>(3), 306–314. [DOI:<a href="https://doi.org/10.1016/j.cmpb.2010.01.007">10.1016/j.cmpb.2010.01.007</a>]</li>
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<li>Zhou, X. F., Shao, Q. X., Han, X. J., Weng, L. J., & Sang, G. W. (1998). Pharmacokinetics of medroxyprogesterone acetate after single and multiple injection of Cyclofem<sup>®</sup> in Chinese women. <em>Contraception</em>, <em>57</em>(6), 405–411. [DOI:<a href="https://doi.org/10.1016/S0010-7824(98)00048-1">10.1016/S0010-7824(98)00048-1</a>]</li>
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</ul>]]></content><author><name>{"first_name"=>"Aly", "last_name"=>"W.", "author-link"=>"/about/#aly", "articles-link"=>"/articles-by-author/aly/"}</name></author><category term="github" /><category term="workspace" /><summary type="html"><![CDATA[An Informal Meta-Analysis of Estradiol Curves with Injectable Estradiol Preparations By Aly | First published July 16, 2021 | Last modified June 23, 2023]]></summary></entry><entry><title type="html">An Exploration of Sublingual Estradiol as an Alternative to Oral Estradiol in Transfeminine People</title><link href="https://transfemscience.org/articles/sublingual-e2-transfem/" rel="alternate" type="text/html" title="An Exploration of Sublingual Estradiol as an Alternative to Oral Estradiol in Transfeminine People" /><published>2021-06-11T20:26:25-07:00</published><updated>2021-09-06T00:00:00-07:00</updated><id>https://transfemscience.org/articles/sublingual-e2-transfem</id><content type="html" xml:base="https://transfemscience.org/articles/sublingual-e2-transfem/"><![CDATA[<h1 id="an-exploration-of-sublingual-estradiol-as-an-alternative-to-oral-estradiol-in-transfeminine-people">An Exploration of Sublingual Estradiol as an Alternative to Oral Estradiol in Transfeminine People</h1>
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</ul>]]></content><author><name>{"first_name"=>"Aly", "last_name"=>"W.", "author-link"=>"/about/#aly", "articles-link"=>"/articles-by-author/aly/"}</name></author><category term="github" /><category term="workspace" /><summary type="html"><![CDATA[An Informal Meta-Analysis of Estradiol Curves with Injectable Estradiol Preparations By Aly | First published July 16, 2021 | Last modified March 18, 2024]]></summary></entry><entry><title type="html">An Exploration of Sublingual Estradiol as an Alternative to Oral Estradiol in Transfeminine People</title><link href="https://transfemscience.org/articles/sublingual-e2-transfem/" rel="alternate" type="text/html" title="An Exploration of Sublingual Estradiol as an Alternative to Oral Estradiol in Transfeminine People" /><published>2021-06-11T20:26:25-07:00</published><updated>2021-09-06T00:00:00-07:00</updated><id>https://transfemscience.org/articles/sublingual-e2-transfem</id><content type="html" xml:base="https://transfemscience.org/articles/sublingual-e2-transfem/"><![CDATA[<h1 id="an-exploration-of-sublingual-estradiol-as-an-alternative-to-oral-estradiol-in-transfeminine-people">An Exploration of Sublingual Estradiol as an Alternative to Oral Estradiol in Transfeminine People</h1>
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<li>Wiegratz, I., Fink, T., Rohr, U. D., Lang, E., Leukel, P., & Kuhl, H. (2001). Überkreuz-Vergleich der Pharmakokinetik von Estradiol unter der Hormonsubstitution mit Estradiolvalerat oder mikronisiertem Estradiol. [Cross-over comparison of the pharmacokinetics of estradiol during hormone replacement therapy with estradiol valerate or micronized estradiol.] <em>Zentralblatt für Gynäkologie</em>, <em>123</em>(9), 505–512. [<a href="https://pubmed.ncbi.nlm.nih.gov/11709743/">PubMed</a>] [DOI:<a href="https://doi.org/10.1055/s-2001-18223">10.1055/s-2001-18223</a>]</li>
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<li>Wisner, K. L., Sit, D. K., Moses-Kolko, E. L., Driscoll, K. E., Prairie, B. A., Stika, C. S., Eng, H. F., Dills, J. L., Luther, J. F., & Wisniewski, S. R. (2015). Transdermal estradiol treatment for postpartum depression: a pilot randomized trial. <em>Journal of Clinical Psychopharmacology</em>, <em>35</em>(4), 389–395. [DOI:<a href="https://doi.org/10.1097/JCP.0000000000000351">10.1097/JCP.0000000000000351</a>]</li>
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<li>Wren, B. G., Day, R. O., McLachlan, A. J., & Williams, K. M. (2003). Pharmacokinetics of estradiol, progesterone, testosterone and dehydroepiandrosterone after transbuccal administration to postmenopausal women. <em>Climacteric</em>, <em>6</em>(2), 104–111. [DOI:<a href="https://doi.org/10.1080/cmt.6.2.104.111">10.1080/cmt.6.2.104.111</a>]</li>
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</ul>]]></content><author><name>{"first_name"=>"Sam", "last_name"=>"S.", "author-link"=>"/about/#sam", "articles-link"=>"/articles-by-author/sam/"}</name></author><category term="github" /><category term="workspace" /><summary type="html"><![CDATA[An Exploration of Sublingual Estradiol as an Alternative to Oral Estradiol in Transfeminine People By Sam | First published June 11, 2021 | Last modified September 6, 2021]]></summary></entry><entry><title type="html">Clinical Guidelines with Information on Transfeminine Hormone Therapy</title><link href="https://transfemscience.org/articles/transfem-hormone-guidelines/" rel="alternate" type="text/html" title="Clinical Guidelines with Information on Transfeminine Hormone Therapy" /><published>2020-11-20T10:00:00-08:00</published><updated>2023-05-23T00:00:00-07:00</updated><id>https://transfemscience.org/articles/transfem-hormone-guidelines</id><content type="html" xml:base="https://transfemscience.org/articles/transfem-hormone-guidelines/"><![CDATA[<h1 id="clinical-guidelines-with-information-on-transfeminine-hormone-therapy">Clinical Guidelines with Information on Transfeminine Hormone Therapy</h1>
|
||||
</ul>]]></content><author><name>{"first_name"=>"Sam", "last_name"=>"S.", "author-link"=>"/about/#sam", "articles-link"=>"/articles-by-author/sam/"}</name></author><category term="github" /><category term="workspace" /><summary type="html"><![CDATA[An Exploration of Sublingual Estradiol as an Alternative to Oral Estradiol in Transfeminine People By Sam | First published June 11, 2021 | Last modified September 6, 2021]]></summary></entry><entry><title type="html">Clinical Guidelines with Information on Transfeminine Hormone Therapy</title><link href="https://transfemscience.org/articles/transfem-hormone-guidelines/" rel="alternate" type="text/html" title="Clinical Guidelines with Information on Transfeminine Hormone Therapy" /><published>2020-11-20T10:00:00-08:00</published><updated>2024-03-21T00:00:00-07:00</updated><id>https://transfemscience.org/articles/transfem-hormone-guidelines</id><content type="html" xml:base="https://transfemscience.org/articles/transfem-hormone-guidelines/"><![CDATA[<h1 id="clinical-guidelines-with-information-on-transfeminine-hormone-therapy">Clinical Guidelines with Information on Transfeminine Hormone Therapy</h1>
|
||||
|
||||
<!-- Supports up to four authors per article currently (author, author2, author3, author4) -->
|
||||
|
||||
<p>By
|
||||
<!-- First author --><a href="/about/#aly">Aly</a><!-- Second author --><!-- Third author --><!-- Fourth author --> | First published November 20, 2020
|
||||
| Last modified May 23, 2023</p>
|
||||
| Last modified March 21, 2024</p>
|
||||
|
||||
<h2 id="abstract--tldr">Abstract / TL;DR</h2>
|
||||
|
||||
|
|
@ -2467,7 +2482,7 @@ Using the term desistence in this way does not imply anything about the identity
|
|||
</thead>
|
||||
<tbody>
|
||||
<tr>
|
||||
<td><a href="https://transcare.ucsf.edu/guidelines">Guidelines for the Primary and Gender-Affirming Care of Transgender and Gender Nonbinary People</a> [<a href="https://transcare.ucsf.edu/sites/transcare.ucsf.edu/files/Transgender-PGACG-6-17-16.pdf">PDF</a>]</td>
|
||||
<td><a href="https://transcare.ucsf.edu/guidelines">Guidelines for the Primary and Gender-Affirming Care of Transgender and Gender Nonbinary People</a> [<a href="https://transcare.ucsf.edu/sites/transcare.ucsf.edu/files/Transgender-PGACG-6-17-16.pdf">PDF</a>] [See also: <a href="https://web.archive.org/web/20111124013938/http://transhealth.ucsf.edu/trans?page=protocol-00-00">1st/2011 edition</a> [<a href="https://files.transfemscience.org/pdfs/UCSF%20(2011)%20-%20Primary%20Care%20Protocol%20for%20Transgender%20Patient%20Care,%201st%20Edition.pdf">PDF</a>]]</td>
|
||||
<td>Deutsch / Center of Excellence for Transgender Health, University of California, San Francisco (UCSF) [San Francisco, California]</td>
|
||||
<td>2016</td>
|
||||
<td>Online document</td>
|
||||
|
|
@ -2737,6 +2752,7 @@ Using the term desistence in this way does not imply anything about the identity
|
|||
|
||||
<ul>
|
||||
<li>AusPATH. (2022). <em>Australian Informed Consent Standards of Care for Gender Affirming Hormone Therapy.</em> Australia: Australian Professional Association for Trans Health. [<a href="https://auspath.org.au/2022/03/31/auspath-australian-informed-consent-standards-of-care-for-gender-affirming-hormone-therapy/">URL</a>] [<a href="https://auspath.org.au/wp-content/uploads/2022/03/AusPATH_Informed-Consent-SoC_A4_2022_FINAL.pdf">PDF</a>]</li>
|
||||
<li>Belzer, M. E., Burnett, J., Deutsch, M., Franicevich, J., Gorton, R. N., Hastings, J., Karasic, D., Kohler, L., Vanderleest, J., Van Maasdam, J., Olson, J., Green, J., & DeVries, C. (April 2011). <em>Primary Care Protocol for Transgender Patient Care, 1st Edition.</em> Center of Excellence for Transgender Health, University of California, San Francisco, Department of Family and Community Medicine. [<a href="https://web.archive.org/web/20111124013938/http://www.transhealth.ucsf.edu:80/trans?page=protocol-00-00">URL</a>] [<a href="https://files.transfemscience.org/pdfs/UCSF%20(2011)%20-%20Primary%20Care%20Protocol%20for%20Transgender%20Patient%20Care,%201st%20Edition.pdf">PDF</a>]</li>
|
||||
<li>Bewley, S., Dahlen, S., Connolly, D., Arif, I., Junejo, M., & Catherine, M. (2021). International Clinical Practice Guidelines for Gender Minority/Trans People: Systematic Review & Quality Assessment. How Does the Endocrine Society Fare? <em>Journal of the Endocrine Society</em>, <em>5</em>(Suppl 1), A791–A791. [DOI:<a href="https://doi.org/10.1210/jendso/bvab048.1609">10.1210/jendso/bvab048.1609</a>]</li>
|
||||
<li>Bourns, A. (2019). <em>Guidelines for Gender-Affirming Primary Care with Trans and Non-Binary Patients, 4th Edition.</em> Toronto: Rainbow Health Ontario/Sherbourne Health. [<a href="https://www.rainbowhealthontario.ca/product/4th-edition-sherbournes-guidelines-for-gender-affirming-primary-care-with-trans-and-non-binary-patients/">URL</a>] [<a href="https://www.rainbowhealthontario.ca/wp-content/uploads/woocommerce_uploads/2019/12/Guidelines-FINAL-4TH-EDITION-n7ozcr.pdf">PDF</a>]</li>
|
||||
<li>Callen-Lorde Community Health Center. (2018). <em>Protocols for the Provision of Hormone Therapy</em>. New York City: Callen-Lorde Community Health Center. [<a href="https://callen-lorde.org/transhealth/">URL</a>] [<a href="https://web.archive.org/web/20221228055728if_/https://callen-lorde.org/graphics/2018/04/Callen-Lorde-TGNC-Hormone-Therapy-Protocols.pdf">PDF</a>]</li>
|
||||
|
|
@ -2779,7 +2795,7 @@ Using the term desistence in this way does not imply anything about the identity
|
|||
<li>Wilczynski, C., & Emanuele, M. A. (2014). Treating a transgender patient: overview of the guidelines. <em>Postgraduate Medicine</em>, <em>126</em>(7), 121–128. [DOI:<a href="https://doi.org/10.3810/pgm.2014.11.2840">10.3810/pgm.2014.11.2840</a>]</li>
|
||||
<li>Wylie, K., Barrett, J., Besser, M., Bouman, W. P., Bridgman, M., Clayton, A., Green, R., Hamilton, M., Hines, M., Ivbijaro, G., Khoosal, D., Lawrence, A., Lenihan, P., Loewenthal, D., Ralph, D., Reed, T., Stevens, J., Terry, T., Thom, B., Thornton, J., Walsh, D., & Ward, D. (2014). Good Practice Guidelines for the Assessment and Treatment of Adults with Gender Dysphoria. <em>Sexual and Relationship Therapy</em>, <em>29</em>(2), 154–214. [DOI:<a href="https://doi.org/10.1080/14681994.2014.883353">10.1080/14681994.2014.883353</a>]</li>
|
||||
<li>Ziegler, E., Carroll, B., & Charnish, E. (2021). Review and Analysis of International Transgender Adult Primary Care Guidelines. <em>Transgender Health</em>, <em>6</em>(3), 139–147. [DOI:<a href="https://doi.org/10.1089/trgh.2020.0043">10.1089/trgh.2020.0043</a>]</li>
|
||||
</ul>]]></content><author><name>{"first_name"=>"Aly", "last_name"=>"W.", "author-link"=>"/about/#aly", "articles-link"=>"/articles-by-author/aly/"}</name></author><category term="github" /><category term="workspace" /><summary type="html"><![CDATA[Clinical Guidelines with Information on Transfeminine Hormone Therapy By Aly | First published November 20, 2020 | Last modified May 23, 2023]]></summary></entry><entry><title type="html">Spironolactone and Claims About Increased Visceral Fat in Transfeminine People</title><link href="https://transfemscience.org/articles/spiro-visceral-fat/" rel="alternate" type="text/html" title="Spironolactone and Claims About Increased Visceral Fat in Transfeminine People" /><published>2020-10-25T09:56:15-07:00</published><updated>2022-10-02T00:00:00-07:00</updated><id>https://transfemscience.org/articles/spiro-visceral-fat</id><content type="html" xml:base="https://transfemscience.org/articles/spiro-visceral-fat/"><![CDATA[<h1 id="spironolactone-and-claims-about-increased-visceral-fat-in-transfeminine-people">Spironolactone and Claims About Increased Visceral Fat in Transfeminine People</h1>
|
||||
</ul>]]></content><author><name>{"first_name"=>"Aly", "last_name"=>"W.", "author-link"=>"/about/#aly", "articles-link"=>"/articles-by-author/aly/"}</name></author><category term="github" /><category term="workspace" /><summary type="html"><![CDATA[Clinical Guidelines with Information on Transfeminine Hormone Therapy By Aly | First published November 20, 2020 | Last modified March 21, 2024]]></summary></entry><entry><title type="html">Spironolactone and Claims About Increased Visceral Fat in Transfeminine People</title><link href="https://transfemscience.org/articles/spiro-visceral-fat/" rel="alternate" type="text/html" title="Spironolactone and Claims About Increased Visceral Fat in Transfeminine People" /><published>2020-10-25T09:56:15-07:00</published><updated>2022-10-02T00:00:00-07:00</updated><id>https://transfemscience.org/articles/spiro-visceral-fat</id><content type="html" xml:base="https://transfemscience.org/articles/spiro-visceral-fat/"><![CDATA[<h1 id="spironolactone-and-claims-about-increased-visceral-fat-in-transfeminine-people">Spironolactone and Claims About Increased Visceral Fat in Transfeminine People</h1>
|
||||
|
||||
<!-- Supports up to four authors per article currently (author, author2, author3, author4) -->
|
||||
|
||||
|
|
@ -4472,13 +4488,13 @@ Using the term desistence in this way does not imply anything about the identity
|
|||
<li>Quaynor, S. D., Stradtman, E. W., Kim, H., Shen, Y., Chorich, L. P., Schreihofer, D. A., & Layman, L. C. (2013). Delayed Puberty and Estrogen Resistance in a Woman with Estrogen Receptor α Variant. <em>New England Journal of Medicine</em>, <em>369</em>(2), 164–171. [DOI:<a href="https://doi.org/10.1056/nejmoa1303611">10.1056/nejmoa1303611</a>]</li>
|
||||
<li>Rinaldi, S., Geay, A., Déchaud, H., Biessy, C., Zeleniuch-Jacquotte, A., Akhmedkhanov, A., Shore, R. E., Riboli, E., Toniolo, P., & Kaaks, R. (2002). Validity of free testosterone and free estradiol determinations in serum samples from postmenopausal women by theoretical calculations. <em>Cancer Epidemiology and Prevention Biomarkers</em>, <em>11</em>(10), 1065–1071. [<a href="https://scholar.google.com/scholar?cluster=18409886331928026045">Google Scholar</a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/12376508/">PubMed</a>] [<a href="https://aacrjournals.org/cebp/article/11/10/1065/166164/Validity-of-Free-Testosterone-and-Free-Estradiol">URL</a>]</li>
|
||||
<li>Vermeulen, A., Verdonck, L., & Kaufman, J. M. (1999). A critical evaluation of simple methods for the estimation of free testosterone in serum. <em>The Journal of Clinical Endocrinology & Metabolism</em>, <em>84</em>(10), 3666–3672. [DOI:<a href="https://doi.org/10.1210/jcem.84.10.6079">10.1210/jcem.84.10.6079</a>]</li>
|
||||
</ul>]]></content><author><name>{"first_name"=>"Aly", "last_name"=>"W.", "author-link"=>"/about/#aly", "articles-link"=>"/articles-by-author/aly/"}</name></author><category term="github" /><category term="workspace" /><summary type="html"><![CDATA[Supplement: The Interactions of Sex Hormones with Sex Hormone-Binding Globulin and Relevance for Transfeminine Hormone Therapy By Aly | First published July 8, 2020 | Last modified March 14, 2023]]></summary></entry><entry><title type="html">Bicalutamide and its Adoption by the Medical Community for Use in Transfeminine Hormone Therapy</title><link href="https://transfemscience.org/articles/bica-adoption/" rel="alternate" type="text/html" title="Bicalutamide and its Adoption by the Medical Community for Use in Transfeminine Hormone Therapy" /><published>2020-07-01T18:39:00-07:00</published><updated>2023-04-17T00:00:00-07:00</updated><id>https://transfemscience.org/articles/bica-adoption</id><content type="html" xml:base="https://transfemscience.org/articles/bica-adoption/"><![CDATA[<h1 id="bicalutamide-and-its-adoption-by-the-medical-community-for-use-in-transfeminine-hormone-therapy">Bicalutamide and its Adoption by the Medical Community for Use in Transfeminine Hormone Therapy</h1>
|
||||
</ul>]]></content><author><name>{"first_name"=>"Aly", "last_name"=>"W.", "author-link"=>"/about/#aly", "articles-link"=>"/articles-by-author/aly/"}</name></author><category term="github" /><category term="workspace" /><summary type="html"><![CDATA[Supplement: The Interactions of Sex Hormones with Sex Hormone-Binding Globulin and Relevance for Transfeminine Hormone Therapy By Aly | First published July 8, 2020 | Last modified March 14, 2023]]></summary></entry><entry><title type="html">Bicalutamide and its Adoption by the Medical Community for Use in Transfeminine Hormone Therapy</title><link href="https://transfemscience.org/articles/bica-adoption/" rel="alternate" type="text/html" title="Bicalutamide and its Adoption by the Medical Community for Use in Transfeminine Hormone Therapy" /><published>2020-07-01T18:39:00-07:00</published><updated>2024-03-20T00:00:00-07:00</updated><id>https://transfemscience.org/articles/bica-adoption</id><content type="html" xml:base="https://transfemscience.org/articles/bica-adoption/"><![CDATA[<h1 id="bicalutamide-and-its-adoption-by-the-medical-community-for-use-in-transfeminine-hormone-therapy">Bicalutamide and its Adoption by the Medical Community for Use in Transfeminine Hormone Therapy</h1>
|
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|
||||
<!-- Supports up to four authors per article currently (author, author2, author3, author4) -->
|
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|
||||
<p>By
|
||||
<!-- First author --><a href="/about/#aly">Aly</a><!-- Second author --><!-- Third author --><!-- Fourth author --> | First published July 1, 2020
|
||||
| Last modified April 17, 2023</p>
|
||||
| Last modified March 20, 2024</p>
|
||||
|
||||
<h2 id="abstract--tldr">Abstract / TL;DR</h2>
|
||||
|
||||
|
|
@ -4570,12 +4586,90 @@ Using the term desistence in this way does not imply anything about the identity
|
|||
|
||||
<p>While unpublished and unverified like the earlier reports of liver toxicity with bicalutamide in transfeminine people, this case represents yet another report, and is notably by far the best-documented one. No other clinical details on the case were provided, and it is unclear whether it involved serious liver toxicity, merely asymptomatic liver function test abnormalities, or a clinical situation somewhere in-between these extremes. In any case, it does seem clear that this instance is not likely to have a positive influence on the further adoption of bicalutamide in transfeminine hormone therapy.</p>
|
||||
|
||||
<p>Subsequent to the investigation of the clinic being launched, in April 2023, Missouri greatly restricted gender-affirming care for transgender youth and adults, with some of the most severe limits that have been enacted in the United States (<a href="https://apnews.com/article/transgender-gender-affirming-care-restrictions-missouri-4def2189dac9979a00d298efb3baf12a">Associated Press, 2023</a>; <a href="https://ago.mo.gov/home/news/2023/04/13/missouri-attorney-general-andrew-bailey-promulgates-emergency-regulation-targeting-gender-transition-procedures-for-minors">Missouri Government, 2023b</a>). Bicalutamide and the liver toxicity instance were not further described with these developments.</p>
|
||||
<p>Subsequent to the investigation of the clinic being launched, in April 2023, Missouri greatly restricted gender-affirming care for transgender youth and adults, with some of the most severe limits that have been enacted in the United States (<a href="https://apnews.com/article/transgender-gender-affirming-care-restrictions-missouri-4def2189dac9979a00d298efb3baf12a">Associated Press, 2023a</a>; <a href="https://ago.mo.gov/home/news/2023/04/13/missouri-attorney-general-andrew-bailey-promulgates-emergency-regulation-targeting-gender-transition-procedures-for-minors">Missouri Government, 2023b</a>). Bicalutamide and the liver toxicity instance were not further described with these developments. The new state law restricting gender-affirming care took effect August 28, 2023, and Washington University announced that it would stop prescribing puberty blockers and hormone therapy to transgender youth shortly thereafter (<a href="https://apnews.com/article/transgender-care-minors-missouri-b65a81c842c6add70529acec231858cd">Associated Press, 2023b</a>).</p>
|
||||
|
||||
<p>A <em>New York Times</em> article with additional information on the case was also subsequently published (<a href="https://www.nytimes.com/2023/08/23/health/transgender-youth-st-louis-jamie-reed.html">Ghorayshi, 2023</a> [<a href="https://archive.is/oqLqD">Excerpts</a>]). It was noted that the adolescent had been on bicalutamide for 1 year and definitely experienced hepatotoxicity. However, she also had a complicated medical history, including being immunocompromised, having recently had COVID-19, and having taken another drug known to be associated with hepatotoxicity. As such, the hepatotoxicity cannot be definitively attributed to bicalutamide, but it simultaneously cannot be ruled out that bicalutamide was involved or causative.</p>
|
||||
|
||||
<h4 id="subsequent-burgener-et-al-2023-2024-findings">Subsequent Burgener et al. (2023, 2024) Findings</h4>
|
||||
|
||||
<p>Following the preceding case, Dr. Lewis and colleagues went on to publish a conference abstract and preprint of a study of bicalutamide in transfeminine youth and young adults in which they stated that it does not increase liver enzymes in this population (<a href="https://karger.com/hrp/article-pdf/96/Suppl.%203/1/4008437/000531602.pdf#page=377">Burgener et al., 2023</a>; <a href="https://www.medrxiv.org/content/10.1101/2024.02.21.24302999v1">Burgener et al., 2024</a>). However, a closer look at their data show that bicalutamide <em>did</em> statistically significantly elevate certain liver parameters relative to other antiandrogens, namely rates of elevated <a href="https://en.wikipedia.org/wiki/Aspartate_transaminase">aspartate aminotransferase</a> (AST) (upper limit of normal 10.7% vs. 1.5%, <em>P</em> = 0.02) (<a href="https://www.medrxiv.org/content/10.1101/2024.02.21.24302999v1">Burgener et al., 2024</a>). Likewise, rates of elevated <a href="https://en.wikipedia.org/wiki/Alanine_transaminase">alanine aminotransferase</a> (ALT) appeared to trend in the direction of being increased, though this was not statistically significant (upper limit of normal 16.7% vs. 11.6%, <em>P</em> = 0.37) (<a href="https://www.medrxiv.org/content/10.1101/2024.02.21.24302999v1">Burgener et al., 2024</a>). In any case, rates of clinically significant elevations in liver enzymes with bicalutamide, defined as greater than three times the upper limit of normal, were not significantly increased in the study.</p>
|
||||
|
||||
<p>On the basis of the relevant research in men with prostate cancer (<a href="https://en.wikipedia.org/wiki/Side_effects_of_bicalutamide#Liver_toxicity">Wiki</a>), Dr. Lewis and colleagues’ study, with a bicalutamide-group sample size of only 84 transfeminine individuals, was clearly greatly <a href="https://en.wikipedia.org/wiki/Power_of_a_test">underpowered</a> for evaluating liver function changes. Per the <a href="https://en.wikipedia.org/wiki/Early_Prostate_Cancer_(clinical_programme)">Early Prostate Cancer trial</a> of high-dose bicalutamide monotherapy in men with prostate cancer, elevated liver enzymes appear to occur with bicalutamide at a rate of only about 1.5% more than placebo, or roughly an additional 1 in every 66 people (<a href="https://en.wikipedia.org/wiki/Side_effects_of_bicalutamide#Liver_toxicity">Wiki</a>). Based on <a href="https://clincalc.com/stats/samplesize.aspx">power analysis</a>, this would require a far larger sample size to have adequate statistical power and actually have a chance of achieving statistical significance.</p>
|
||||
|
||||
<p>As such, it seems to the present author premature to conclude that bicalutamide does not elevate liver enzymes in transfeminine people.</p>
|
||||
|
||||
<p>Dr. Lewis and colleagues didn’t mention in their study paper the transfeminine adolescent liver toxicity case reported by Jamie Reed that was said to have occurred at their clinic nor have they published a case report about this instance. Instead, only the following is stated:</p>
|
||||
|
||||
<blockquote>
|
||||
<p>One case report published in 2024 described a transgender female adolescent prescribed bicalutamide 50 mg daily who presented to a hospital with liver toxicity that resolved after stopping bicalutamide (Wilde et al., 2024). This appears to be the first documented case of bicalutamide-induced hepatoxicity in a transgender female.</p>
|
||||
</blockquote>
|
||||
|
||||
<p>While this case was, coincidentally, also a 17-year-old transfeminine adolescent (<a href="https://doi.org/10.1016/j.jadohealth.2023.08.024">Wilde et al., 2024</a>), this instance, per the medical histories and reporting authors/institutions, appears to be distinct from Dr. Lewis’s that was reported by Jamie Reed.</p>
|
||||
|
||||
<p>However, Dr. Lewis and colleagues did note the following in their paper, which plausibly might have been the Jamie Reed case:</p>
|
||||
|
||||
<blockquote>
|
||||
<p>There was one individual in whom bicalutamide was stopped after the follow-up period designated for the study. This individual developed ALT and AST >2x ULN after an episode of COVID and had a thorough hepatology evaluation. As ALT and AST were never > 3x ULN, it was not recommended that bicalutamide be stopped; however, ultimately a clinical decision was made to stop the medication and ALT and AST normalized.</p>
|
||||
</blockquote>
|
||||
|
||||
<p>Another concern with Dr. Lewis and colleagues’ paper pertains to the following statements:</p>
|
||||
|
||||
<blockquote>
|
||||
<p>Whereas bicalutamide doses for prostate cancer reach 150 mg daily, doses used in the care of AMAB transfeminine individuals are much lower (25-50 mg daily).</p>
|
||||
</blockquote>
|
||||
|
||||
<blockquote>
|
||||
<p>Bicalutamide doses used in prostate cancer are up to 150 mg daily. Due to these concerns of liver toxicity, bicalutamide has not been routinely used as an anti-androgen in AMAB transfeminine individuals, despite the much lower doses needed in this population (∼25-50 mg daily).</p>
|
||||
</blockquote>
|
||||
|
||||
<p>In actuality, bicalutamide is most widely used in prostate cancer, in the form of combined androgen blockade with surgical or medical castration, at a dosage of 50 mg/day, whereas the 150 mg/day dosage is used less commonly, in the form of monotherapy (<a href="https://en.wikipedia.org/wiki/Bicalutamide">Wiki</a>). Among the published case reports of hepatotoxicity with bicalutamide in men with prostate cancer, half have been at a dose of 50 mg/day and the other half have been at a dose of 80 to 150 mg/day (<a href="https://en.wikipedia.org/wiki/Template:Published_case_reports_of_bicalutamide-associated_liver_injury">Wiki</a>). The two instances of death due to hepatotoxicity with bicalutamide were both at 50 mg/day. There is currently no evidence that the hepatotoxicity of bicalutamide is dose-dependent across its clinically used dosage range (<a href="https://en.wikipedia.org/wiki/Side_effects_of_bicalutamide#Liver_toxicity">Wiki</a>), although employment of the lowest effective dose in transfeminine people nonetheless seems prudent just in case. Hence, in contrast to Dr. Lewis and colleague’s claims, a bicalutamide dosage of 50 mg/day is not less than that used in prostate cancer, and clearly retains substantial hepatotoxic potential.</p>
|
||||
|
||||
<h3 id="update-5-new-2022-2023-and-2024-bicalutamide-publications">Update 5: New 2022, 2023, and 2024 Bicalutamide Publications</h3>
|
||||
|
||||
<h4 id="2022">2022</h4>
|
||||
|
||||
<ul>
|
||||
<li>Angus, L., Nolan, B., Zajac, J., & Cheung, A. (November 2022). Use of bicalutamide as an androgen receptor antagonist in transgender women. <em>ESA/SRB/APEG/NZSE ASM 2022, November 13-16, Christchurch, Abstracts and Programme</em>, 127–127 (abstract no. 280). [<a href="https://esa-srb-apeg-nzse-2022.p.asnevents.com.au/days/2022-11-14/abstract/85266">URL</a>] [<a href="https://files.transfemscience.org/pdfs/Angus%20et%20al.%20(2022)%20-%20Use%20of%20bicalutamide%20as%20an%20androgen%20receptor%20antagonist%20in%20transgender%20women%20(ESA-SRB-APEG-NZSE%20ASM%202022,%20abstract%20no.%20280).pdf">PDF</a>] [<a href="https://www.endocrinesociety.org.au/esa-srb-apeg-nzse-2022-program_abstracts.pdf#page=127">Full Abstract Book</a>]</li>
|
||||
</ul>
|
||||
|
||||
<h4 id="2023">2023</h4>
|
||||
|
||||
<ul>
|
||||
<li>Angus, L. M., Nolan, B. J., Zajac, J. D., & Cheung, A. S. (November 2023). Bicalutamide as an anti-androgen in trans people: a cross-sectional study. <em>AusPATH 2023 Symposium</em>. [<a href="https://ashm.eventsair.com/QuickEventWebsitePortal/auspath-conference-2023/aus24/Agenda/AgendaItemDetail?id=0c7c2d1d-21c4-4b21-920f-99446f96a548">URL</a>] [<a href="https://az659834.vo.msecnd.net/eventsairaueprod/production-ashm-public/071ac7b75cbe4d35a6fa168110ea3070">PDF</a>] [<a href="https://files.transfemscience.org/pdfs/misc/Angus%20et%20al.%20AUSPATH%202023%20Bicalutamide%20Study%20Slides.pdf">Slides</a>] [<a href="https://www.transresearch.org.au/post/2023_auspath">Trans Health Research Blog Post</a>]</li>
|
||||
<li>Bambilla, A., Beal, C., & Vigil, P. (2023). Improving Access to Bicalutamide in Gender Affirming Medical Care. [Unpubished/pending publication] [<a href="https://www.queercme.com/blog/bicalutamide-prescribing-in-gender-affirming-care">QueerCME Blog Post</a>]</li>
|
||||
<li>Burgener, K., DeBosch, B., Lewis, C., Wallendorf, M., & Herrick, C. (May 2023). Assessment of Liver Function and Toxicity in Transgender Female Adolescents Prescribed Bicalutamide. <em>Hormone Research in Paediatrics</em>, <em>96</em>(Suppl 3 [<em>Abstracts of the 2023 Pediatric Endocrine Society (PES) Annual Meeting’ to Hormone Research in Paediatrics</em>]): 377–378 (abstract no. 6232). [DOI:<a href="https://doi.org/10.1159/000531602">10.1159/000531602</a>] [<a href="https://files.transfemscience.org/pdfs/Burgener%20et%20al.%20(2023)%20-%20Assessment%20of%20Liver%20Function%20and%20Toxicity%20in%20Transgender%20Female%20Adolescents%20Prescribed%20Bicalutamide%20(PES%202023,%20abstract%20ID%206232).pdf">PDF</a>]</li>
|
||||
<li>Gómez-Aguilar, F., Martínez-Sánchez, L., Arias-Constantí, V., Muñoz-Santanach, D., & Sarquella-Brugada, G. (2023). QT prolongation and Torsade de Pointes in a 13-year-old transgender adolescent in treatment with bicalutamide and tacrolimus. <em>Clinical Toxicology</em>, <em>61</em>(Suppl 1 [<em>43rd International Congress of the European Association of Poisons Centres and Clinical Toxicologists (EAPCCT), 23–26 May 2023, Palma de Mallorca, Spain</em>]), 81–82 (abstract no. 170). [DOI:<a href="https://doi.org/10.1080/15563650.2023.2192024">10.1080/15563650.2023.2192024</a>] [<a href="https://www.eapcct.org/publicfile.php?folder=congress&file=Abstracts_Mallorca23.pdf#page=81">PDF</a>] [<a href="https://doi.org/10.1007/s40278-023-45800-4">Reactions Weekly</a>]</li>
|
||||
<li>Karakılıç Özturan, E., Öztürk, A. P., Baş, F., Erdoğdu, A. B., Kaptan, S., Kardelen Al, A. D., Poyrazoğlu, Ş., Yıldız, M., Direk, N., Yüksel, Ş., & Darendeliler, F. (2023). Endocrinological Approach to Adolescents with Gender Dysphoria: Experience of a Pediatric Endocrinology Department in a Tertiary Center in Turkey. <em>Journal of Clinical Research in Pediatric Endocrinology</em>, <em>15</em>(3), 276–284. [DOI:<a href="https://doi.org/10.4274/jcrpe.galenos.2023.2023-1-13">10.4274/jcrpe.galenos.2023.2023-1-13</a>]</li>
|
||||
<li>Vierregger, K., Tetzlaff, M., Zimmerman, B., Dunn, N., Finney, N., Lewis, K., Slomoff, R., & Strutner, S. (May 2023). Bicalutamide Use as Antiandrogen in Trans Feminine Adults - A Safety Profile. <em>National Transgender Health Summit (NTHS) 2023 Symposium</em>. [<a href="https://web.archive.org/web/20240321010915/https://d1keuthy5s86c8.cloudfront.net/static/ems/upload/files/nyhs_202305_agenda_pdf_lbjyz.pdf">Event Agenda PDF</a>] [<a href="https://whova.com/embedded/session/D7SYg0LqOnCqwqXqLsWNIdaSkH1LCYZ1IG6HZi0Pc-U%3D/3000743/">Symposium Session</a>] [<a href="https://prevention.ucsf.edu/transhealth/education/nths">Symposium Abstracts/Program Book</a>]</li>
|
||||
<li>Vierregger, K. S. (November 2023). Bicalutamide Use as Antiandrogen in Trans Feminine Adults - A Safety Profile. <em>USPATH 2023 Symposium</em>. [<a href="https://www.wpath.org/media/cms/Upcoming%20Conferences/2023/Schedules/Final%20USPATH%202023%20Scientific%20Symposium%20Main%20Program%20-%20Full%20Schedule.pdf">Symposium Schedule</a>]</li>
|
||||
<li>Warus, J. (November 2023). Safety of Bicalutamide as Anti-Androgenic Therapy in Gender Affirming Care for Adolescents and Young Adults: A Retrospective Chart Review. <em>USPATH 2023 Symposium</em>. [<a href="https://www.wpath.org/media/cms/Upcoming%20Conferences/2023/Schedules/Final%20USPATH%202023%20Scientific%20Symposium%20Main%20Program%20-%20Full%20Schedule.pdf">Symposium Schedule</a>]</li>
|
||||
<li>Wilde, B., Diamond, J. B., Laborda, T. J., Frank, L., O’Gorman, M. A., & Kocolas, I. (2023). Bicalutamide-Induced Hepatotoxicity in a Transgender Male-to-Female Adolescent. <em>Journal of Adolescent Health</em>, <em>74</em>(1), 202–204. [DOI:<a href="https://doi.org/10.1016/j.jadohealth.2023.08.024">10.1016/j.jadohealth.2023.08.024</a>]</li>
|
||||
</ul>
|
||||
|
||||
<h4 id="2024">2024</h4>
|
||||
|
||||
<ul>
|
||||
<li>Burgener, K., DeBosch, B., Wang, J., Lewis, C., & Herrick, C. J. (2024). Bicalutamide does not raise transaminases in comparison to alternative anti-androgen regimens among transfeminine adolescents and young adults: a retrospective cohort study. <em>medRxiv</em>, preprint. [DOI:<a href="https://www.medrxiv.org/content/10.1101/2024.02.21.24302999v1">10.1101/2024.02.21.24302999v1</a>] [<a href="https://www.medrxiv.org/content/medrxiv/early/2024/02/23/2024.02.21.24302999.full.pdf">PDF</a>]</li>
|
||||
<li>Fuqua, J. S., Shi, E., & Eugster, E. A. (2024). A retrospective review of the use of bicalutamide in transfeminine youth; a single center experience. <em>International Journal of Transgender Health</em>, advance online publication. [DOI:<a href="https://doi.org/10.1080/26895269.2023.2294321">10.1080/26895269.2023.2294321</a>]</li>
|
||||
<li>Shumer, D., & Roberts, S. A. (2024). Placing a Report of Bicalutamide-Induced Hepatotoxicity in the Context of Current Standards of Care for Transgender Adolescents. <em>Journal of Adolescent Health</em>, <em>74</em>(1), 5–6. [DOI:<a href="https://doi.org/10.1016/j.jadohealth.2023.10.010">10.1016/j.jadohealth.2023.10.010</a>]</li>
|
||||
</ul>
|
||||
|
||||
<h3 id="update-6-original-bicalutamide-liver-and-lung-toxicity-analysis-by-sam">Update 6: Original Bicalutamide Liver and Lung Toxicity Analysis by Sam</h3>
|
||||
|
||||
<p>A few years ago back in 2021, Transfeminine Science author <a href="/about/#sam">Sam</a> conducted an original analysis of the incidence of liver and lung toxicity with bicalutamide in the published clinical trial literature. This project was never finished or made publicly available. However, with bicalutamide being increasingly studied and adopted for use in transfeminine people, it seems quite valuable and relevant today. As such, we have opted to now publish Sam’s analysis in this section.</p>
|
||||
|
||||
<p>Sam’s analysis can be found in the provided document <a href="https://files.transfemscience.org/pdfs/docs/Supplementary%20Material_%20Liver%20and%20Lung%20Toxicity%20with%20Bicalutamide%20in%20Clinical%20Trials.pdf">here</a>. In terms of methodology, she searched <a href="https://pubmed.ncbi.nlm.nih.gov/">PubMed</a> for all clinical trials of bicalutamide, collated all of the relevant results into a table, and then calculated the incidences of serious liver toxicity and lung toxicity from those data. In clinical trials, adverse events are rated in terms of grades of severity, with a Grade 3 adverse event defined as “severe”, Grade 4 as “life-threatening”, and Grade 5 as “death” (<a href="https://en.wikipedia.org/wiki/Common_Terminology_Criteria_for_Adverse_Events">Wiki</a>).</p>
|
||||
|
||||
<p>Of 229 results, 33 trials were found to be relevant and were included. Most of the trials were in men with prostate cancer, but a few were in women with cancer and boys with precocious puberty. Sam found that of a total of 7,703 evaluable participants, there were 2 instances of serious liver toxicity and 2 instances of serious lung toxicity with bicalutamide. This resulted in the same incidence rate of 0.026% (95% CI: 0.003% to 0.094%) or approximately 1 in 3,846 individuals for both liver toxicity and lung toxicity. Combining these toxicities resulted in a total incidence of serious liver <em>or</em> serious lung toxicity with bicalutamide of 0.052% (95% CI: 0.014% to 0.133%) or approximately 1 in 1,923 individuals. All of the observed toxicity events were rated as Grade 3 or 4. It should be noted that clinical trials of bicalutamide typically employ careful laboratory monitoring and assessment of clinical adverse events as well as prompt medication discontinuation upon unfavorable laboratory changes.</p>
|
||||
|
||||
<p>While the <a href="https://en.wikipedia.org/wiki/Confidence_interval">confidence intervals</a> (CIs) in Sam’s analysis were wide and hence the estimates are very rough, they provide an idea of the potential real-world risk of serious toxicity with bicalutamide in transfeminine people based on high-quality clinical data. Notably, they do not suffer from the problem of <a href="https://en.wikipedia.org/wiki/Under-reporting">under-reporting</a> of adverse events that occurs with published <a href="https://en.wikipedia.org/wiki/Case_report">case reports</a>, <a href="https://en.wikipedia.org/wiki/Pharmacovigilance">pharmacovigilance databases</a>, and certain types of <a href="https://en.wikipedia.org/wiki/Observational_study">observational studies</a>. However, limitations of Sam’s analysis include (1) toxicity incidence rates for no-bicalutamide controls not being assessed and (2) most of the patients having cancer and being of older age, and hence the generalizability of the findings to healthy transfeminine people not being fully clear. In any case, I was surprised by how high the incidence rates were when I first saw her analysis, and I suspect that others may be as well.</p>
|
||||
|
||||
<h2 id="references">References</h2>
|
||||
|
||||
<ul>
|
||||
<li>Anderson, J. (2003). The role of antiandrogen monotherapy in the treatment of prostate cancer. <em>BJU International</em>, <em>91</em>(5), 455–461. [DOI:<a href="https://doi.org/10.1046/j.1464-410X.2003.04026.x">10.1046/j.1464-410X.2003.04026.x</a>]</li>
|
||||
<li>Angus, L., Nolan, B., Zajac, J., & Cheung, A. (2022). Use of bicalutamide as an androgen receptor antagonist in transgender women. <em>ESA/SRB/APEG/NZSE ASM 2022, November 13-16, Christchurch, Abstracts and Programme</em>, 127–127 (abstract no. 280). [<a href="https://esa-srb-apeg-nzse-2022.p.asnevents.com.au/days/2022-11-14/abstract/85266">URL</a>] [<a href="https://files.transfemscience.org/pdfs/Angus%20et%20al.%20(2022)%20-%20Use%20of%20bicalutamide%20as%20an%20androgen%20receptor%20antagonist%20in%20transgender%20women%20(ESA-SRB-APEG-NZSE%20ASM%202022,%20abstract%20no.%20280).pdf">PDF</a>] [<a href="https://www.endocrinesociety.org.au/esa-srb-apeg-nzse-2022-program_abstracts.pdf#page=127">Full Abstract Book</a>]</li>
|
||||
<li>Angus, L. M., Nolan, B. J., Zajac, J. D., & Cheung, A. S. (2023). Bicalutamide as an anti-androgen in trans people: a cross-sectional study. <em>AusPATH 2023 Symposium</em>. [<a href="https://ashm.eventsair.com/QuickEventWebsitePortal/auspath-conference-2023/aus24/Agenda/AgendaItemDetail?id=0c7c2d1d-21c4-4b21-920f-99446f96a548">URL</a>] [<a href="https://az659834.vo.msecnd.net/eventsairaueprod/production-ashm-public/071ac7b75cbe4d35a6fa168110ea3070">PDF</a>] [<a href="https://files.transfemscience.org/pdfs/misc/Angus%20et%20al.%20AUSPATH%202023%20Bicalutamide%20Study%20Slides.pdf">Slides</a>] [<a href="https://www.transresearch.org.au/post/2023_auspath">Trans Health Research Blog Post</a>]</li>
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<li>Asscheman, H., Gooren, L. J., & Peereboom-Wynia, J. D. (1989). Reduction in undesired sexual hair growth with anandron in male-to-female transsexuals—experiences with a novel androgen receptor blocker. <em>Clinical and Experimental Dermatology</em>, <em>14</em>(5), 361–363. [DOI:<a href="https://doi.org/10.1111/j.1365-2230.1989.tb02585.x">10.1111/j.1365-2230.1989.tb02585.x</a>]</li>
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||||
<li>Asscheman, H., & Gooren, L. J. (1992). Hormone Treatment in Transsexuals. In Bocking, W. O., Coleman, E. (Eds). <em>Gender Dysphoria: Interdisciplinary Approaches in Clinical Management</em> (pp. 39–54). Binghamton: Haworth Press. / <em>Journal of Psychology & Human Sexuality</em>, <em>5</em>(4), 39–54. [<a href="https://scholar.google.com/scholar?cluster=3926911364428297742">Google Scholar</a>] [<a href="https://books.google.com/books?id=fny-DwAAQBAJ&pg=PT38">Google Books</a>] [DOI:<a href="https://doi.org/10.1300/J056v05n04_03">10.1300/J056v05n04_03</a>]</li>
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||||
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@ -4584,7 +4678,10 @@ Using the term desistence in this way does not imply anything about the identity
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|||
<li>Bailey, A. (2023 February 9). <em>Missouri Attorney General Andrew Bailey Confirms Launch of Multi-Agency Investigation into St. Louis Transgender Center for Harming Hundreds of Children.</em> Attorney General Andrew Bailey, Missouri Government. [<a href="https://ago.mo.gov/home/news/2023/02/09/missouri-attorney-general-andrew-bailey-confirms-launch-of-multi-agency-investigation-into-st.-louis-transgender-center-for-harming-hundreds-of-children">URL</a>] [<a href="https://ago.mo.gov/docs/default-source/press-releases/2-07-2023-reed-affidavit---signed.pdf">Affadavit of Jamie Reed</a>]</li>
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||||
<li>Bailey, A. (2023 April 13). <em>Missouri Attorney General Andrew Bailey Promulgates Emergency Regulation Targeting Gender Transition Procedures for Minors.</em> Attorney General Andrew Bailey, Missouri Government. [<a href="https://ago.mo.gov/home/news/2023/04/13/missouri-attorney-general-andrew-bailey-promulgates-emergency-regulation-targeting-gender-transition-procedures-for-minors">URL</a>] [<a href="https://ago.mo.gov/docs/default-source/press-releases/2023-04-13---emergency-reg.pdf">Emergency Regulation PDF</a>]</li>
|
||||
<li>Ballentine, S., & Hollingsworth, H. (2023 April 13). Missouri to limit gender-affirming care for minors, adults. <em>Associated Press.</em> [<a href="https://apnews.com/article/transgender-gender-affirming-care-restrictions-missouri-4def2189dac9979a00d298efb3baf12a">URL</a>]</li>
|
||||
<li>Bambilla, A., Beal, C., & Vigil, P. (2023). Improving Access to Bicalutamide in Gender Affirming Medical Care. [Unpubished/pending publication] [<a href="https://www.queercme.com/blog/bicalutamide-prescribing-in-gender-affirming-care">QueerCME Blog Post</a>]</li>
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||||
<li>Blackledge, G. R. P. (1996). Clinical progress with a new antiandrogen, Casodex™ (bicalutamide). <em>European Urology</em>, <em>29</em>(Suppl 2), 96–104. [DOI:<a href="https://doi.org/10.1159/000473847">10.1159/000473847</a>]</li>
|
||||
<li>Burgener, K., DeBosch, B., Lewis, C., Wallendorf, M., & Herrick, C. (2023). Assessment of Liver Function and Toxicity in Transgender Female Adolescents Prescribed Bicalutamide. <em>Hormone Research in Paediatrics</em>, <em>96</em>(Suppl 3 [<em>Abstracts of the 2023 Pediatric Endocrine Society (PES) Annual Meeting’ to Hormone Research in Paediatrics</em>]): 377–378 (abstract no. 6232). [DOI:<a href="https://doi.org/10.1159/000531602">10.1159/000531602</a>] [<a href="https://files.transfemscience.org/pdfs/Burgener%20et%20al.%20(2023)%20-%20Assessment%20of%20Liver%20Function%20and%20Toxicity%20in%20Transgender%20Female%20Adolescents%20Prescribed%20Bicalutamide%20(PES%202023,%20abstract%20ID%206232).pdf">PDF</a>]</li>
|
||||
<li>Burgener, K., DeBosch, B., Wang, J., Lewis, C., & Herrick, C. J. (2024). Bicalutamide does not raise transaminases in comparison to alternative anti-androgen regimens among transfeminine adolescents and young adults: a retrospective cohort study. <em>medRxiv</em>, preprint. [DOI:<a href="https://www.medrxiv.org/content/10.1101/2024.02.21.24302999v1">10.1101/2024.02.21.24302999v1</a>] [<a href="https://www.medrxiv.org/content/medrxiv/early/2024/02/23/2024.02.21.24302999.full.pdf">PDF</a>]</li>
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||||
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||||
<li>Coleman, E., Radix, A. E., Bouman, W. P., Brown, G. R., de Vries, A. L., Deutsch, M. B., Ettner, R., Fraser, L., Goodman, M., Green, J., Hancock, A. B., Johnson, T. W., Karasic, D. H., Knudson, G. A., Leibowitz, S. F., Meyer-Bahlburg, H. F., Monstrey, S. J., Motmans, J., Nahata, L., … & Arcelus, J. (2022). [World Professional Association for Transgender Health (WPATH)] Standards of Care for the Health of Transgender and Gender Diverse People, Version 8. <em>International Journal of Transgender Health</em>, <em>23</em>(Suppl 1), S1–S259. [DOI:<a href="https://doi.org/10.1080/26895269.2022.2100644">10.1080/26895269.2022.2100644</a>] [<a href="https://www.wpath.org/publications/soc">URL</a>] [<a href="https://www.tandfonline.com/doi/pdf/10.1080/26895269.2022.2100644">PDF</a>]</li>
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||||
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||||
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@ -4597,6 +4694,9 @@ Using the term desistence in this way does not imply anything about the identity
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|||
<li>Finkle, A., Zavertnik, S., Myers, S., Cormier, D., Heithaus, J., & Augustyn, M. (2020). Growing Up Fast: Managing Autism Spectrum Disorder and Precocious Puberty. <em>Journal of Developmental and Behavioral Pediatrics: JDBP</em>, <em>41</em>(9), 740–742. [DOI:<a href="https://doi.org/10.1097/DBP.0000000000000865">10.1097/DBP.0000000000000865</a>]</li>
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<li>Fishman, S. L., Paliou, M., Poretsky, L., & Hembree, W. C. (2019). Endocrine Care of Transgender Adults. In Poretsky, L., & Hembree, W. C. (Eds.). <em>Transgender Medicine</em> (pp. 143–163). Cham: Humana Press. [DOI:<a href="https://doi.org/10.1007/978-3-030-05683-4_8">10.1007/978-3-030-05683-4_8</a>]</li>
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||||
<li>Food and Drug Administration (FDA). (2017). <em>CASODEX (bicalutamide) tablet, for oral use.</em> [<a href="https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm?event=overview.process&ApplNo=020498">URL</a>] [<a href="https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/020498s028lbl.pdf">PDF</a>]</li>
|
||||
<li>Fuqua, J. S., Shi, E., & Eugster, E. A. (2024). A retrospective review of the use of bicalutamide in transfeminine youth; a single center experience. <em>International Journal of Transgender Health</em>, advance online publication. [DOI:<a href="https://doi.org/10.1080/26895269.2023.2294321">10.1080/26895269.2023.2294321</a>]</li>
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||||
<li>Ghorayshi, A. (2023 August 29). How a Small Gender Clinic Landed in a Political Storm. <em>The New York Times</em>. [<a href="https://www.nytimes.com/2023/08/23/health/transgender-youth-st-louis-jamie-reed.html">URL</a>]</li>
|
||||
<li>Gómez-Aguilar, F., Martínez-Sánchez, L., Arias-Constantí, V., Muñoz-Santanach, D., & Sarquella-Brugada, G. (2023). QT prolongation and Torsade de Pointes in a 13-year-old transgender adolescent in treatment with bicalutamide and tacrolimus. <em>Clinical Toxicology</em>, <em>61</em>(Suppl 1 [<em>43rd International Congress of the European Association of Poisons Centres and Clinical Toxicologists (EAPCCT), 23–26 May 2023, Palma de Mallorca, Spain</em>]), 81–82 (abstract no. 170). [DOI:<a href="https://doi.org/10.1080/15563650.2023.2192024">10.1080/15563650.2023.2192024</a>] [<a href="https://www.eapcct.org/publicfile.php?folder=congress&file=Abstracts_Mallorca23.pdf#page=81">PDF</a>] [<a href="https://doi.org/10.1007/s40278-023-45800-4">Reactions Weekly</a>]</li>
|
||||
<li>Gooren, L., Spinder, T., Spijkstra, J. J., Van Kessel, H., Smals, A., Rao, B. R., & Hoogslag, M. (1987). Sex steroids and pulsatile luteinizing hormone release in men. Studies in estrogen-treated agonadal subjects and eugonadal subjects treated with a novel nonsteroidal antiandrogen. <em>The Journal of Clinical Endocrinology & Metabolism</em>, <em>64</em>(4), 763–770. [DOI:<a href="https://doi.org/10.1210/jcem-64-4-763">10.1210/jcem-64-4-763</a>]</li>
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||||
<li>Gooren, L. J. G. (1999). Hormonal Sex Reassignment. <em>International Journal of Transgenderism</em>, <em>3</em>(3), 1–7. [<a href="https://scholar.google.com/scholar?cluster=1501455977722930279">Google Scholar</a>] [<a href="http://web.archive.org/web/20070430161048/http://www.symposion.com/ijt/ijt990301.htm">URL</a>] [<a href="http://www.tgmeds.org.uk/hormonal-sex-reassignment.html">Alt</a>]</li>
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@ -4611,6 +4711,7 @@ Using the term desistence in this way does not imply anything about the identity
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<li>Iversen, P., Johansson, J. E., Lodding, P., Lukkarinen, O., Lundmo, P., Klarskov, P., Tammela, T. L., Tasdemir, I., Morris, T., Carroll, K., & Scandinavian Prostatic Cancer Group. (2004). Bicalutamide (150 mg) versus placebo as immediate therapy alone or as adjuvant to therapy with curative intent for early nonmetastatic prostate cancer: 5.3-year median followup from the Scandinavian Prostate Cancer Group Study Number 6. <em>The Journal of Urology</em>, <em>172</em>(5 Part 1), 1871–1876. [DOI:<a href="https://doi.org/10.1097/01.ju.0000139719.99825.54">10.1097/01.ju.0000139719.99825.54</a>]</li>
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<li>Iwamoto, S. J., Defreyne, J., Rothman, M. S., Van Schuylenbergh, J., Van de Bruaene, L., Motmans, J., & T’Sjoen, G. (2019). Health considerations for transgender women and remaining unknowns: a narrative review. <em>Therapeutic Advances in Endocrinology and Metabolism</em>, <em>10</em>, 2042018819871166. [DOI:<a href="https://doi.org/10.1177%2F2042018819871166">10.1177/2042018819871166</a>]</li>
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<li>Karakılıç Özturan, E., Öztürk, A. P., Baş, F., Erdoğdu, A. B., Kaptan, S., Kardelen Al, A. D., Poyrazoğlu, Ş., Yıldız, M., Direk, N., Yüksel, Ş., & Darendeliler, F. (2023). Endocrinological Approach to Adolescents with Gender Dysphoria: Experience of a Pediatric Endocrinology Department in a Tertiary Center in Turkey. <em>Journal of Clinical Research in Pediatric Endocrinology</em>, <em>15</em>(3), 276–284. [DOI:<a href="https://doi.org/10.4274/jcrpe.galenos.2023.2023-1-13">10.4274/jcrpe.galenos.2023.2023-1-13</a>]</li>
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@ -4637,7 +4738,9 @@ Using the term desistence in this way does not imply anything about the identity
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<li>Rao, B. R., De Voogt, H. J., Geldof, A. A., Gooren, L. J. G., & Bouman, F. G. (1988). Merits and considerations in the use of anti-androgen. <em>Journal of Steroid Biochemistry</em>, <em>31</em>(4), 731–737. [DOI:<a href="https://doi.org/10.1016/0022-4731(88)90024-6">10.1016/0022-4731(88)90024-6</a>]</li>
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<li>Schellhammer, P. F., Sharifi, R., Block, N. L., Soloway, M. S., Venner, P. M., Patterson, A. L., Sarosdy, M. F., Vogelzang, N. J., Schellenger, J. J., Kolvenbag, G. J., & Casodex Combination Study Group. (1997). Clinical benefits of bicalutamide compared with flutamide in combined androgen blockade for patients with advanced prostatic carcinoma: final report of a double-blind, randomized, multicenter trial. <em>Urology</em>, <em>50</em>(3), 330–336. [DOI:<a href="https://doi.org/10.1016/s0090-4295(97)00279-3">10.1016/s0090-4295(97)00279-3</a>]</li>
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<li>See, W. A., Wirth, M. P., McLeod, D. G., Iversen, P., Klimberg, I., Gleason, D., Chodak, G., Montie, J., Tyrrell, C., Wallace, D. M., Delaere, K. P., Vaage, S., Tammela, T. L., Lukkarinen, O., Persson, B. E., Carroll, K., Kolvenbag, G. J., & Casodex Early Prostate Cancer Trialist Group. (2002). Bicalutamide as immediate therapy either alone or as adjuvant to standard care of patients with localized or locally advanced prostate cancer: first analysis of the early prostate cancer program. <em>The Journal of Urology</em>, <em>168</em>(2), 429–435. [DOI:<a href="https://doi.org/10.1016/S0022-5347(05)64652-6">10.1016/S0022-5347(05)64652-6</a>]</li>
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<li>Stenger, P. J., Wagner, L., Egelhoff, J., & Rose, S. R. (2009). Bicalutamide and letrozole treatment of precocious puberty due to elevated levels of human chorionic gonadotropin (hCG). <em>Hormone Research</em> [<em>in Paediatrics</em>], <em>72</em>(Suppl 3), 391–391 (PO3-149). [<a href="https://scholar.google.com/scholar?cluster=9944726539277415138">Google Scholar</a>] [DOI:<a href="https://doi.org/10.1159/000239668">10.1159/000239668</a>]</li>
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|||
<li>Thompson, J., Hopwood, R. A., deNormand, S., & Cavanaugh, T. (2021). <em>Medical Care of Trans and Gender Diverse Adults.</em> Boston: Fenway Health. [<a href="https://www.lgbtqiahealtheducation.org/publication/medical-care-of-trans-and-gender-diverse-adults-2021/">URL</a>] [<a href="https://www.lgbtqiahealtheducation.org/wp-content/uploads/2021/07/Medical-Care-of-Trans-and-Gender-Diverse-Adults-Spring-2021.pdf">PDF</a>]</li>
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<li>Tomson, A., McLachlan, C., Wattrus, C., Adams, K., Addinall, R., Bothma, R., Jankelowitz, L., Kotze, E., Luvuno, Z., Madlala, N., Matyila, S., Padavatan, A., Pillay, M., Rakumakoe, M. D., Tomson-Myburgh, M., Venter, W., & de Vries, E. (2021). Southern African HIV Clinicians’ Society gender-affirming healthcare guideline for South Africa. <em>Southern African Journal of HIV Medicine</em>, <em>22</em>(1), a1299. [DOI:<a href="https://doi.org/10.4102/sajhivmed.v22i1.1299">10.4102/sajhivmed.v22i1.1299</a>] [<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8517808/pdf/HIVMED-22-1299.pdf">PDF</a>]</li>
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<li>van Kemenade, J. F., Cohen-Kettenis, P. T., Cohen, L., & Gooren, L. J. (1989). Effects of the pure antiandrogen RU 23.903 (anandron) on sexuality, aggression, and mood in male-to-female transsexuals. <em>Archives of Sexual Behavior</em>, <em>18</em>(3), 217–228. [DOI:<a href="https://doi.org/10.1007/BF01543196">10.1007/BF01543196</a>]</li>
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</ul>]]></content><author><name>{"first_name"=>"Aly", "last_name"=>"W.", "author-link"=>"/about/#aly", "articles-link"=>"/articles-by-author/aly/"}</name></author><category term="github" /><category term="workspace" /><summary type="html"><![CDATA[Bicalutamide and its Adoption by the Medical Community for Use in Transfeminine Hormone Therapy By Aly | First published July 1, 2020 | Last modified April 17, 2023]]></summary></entry></feed>
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<li>Vierregger, K., Tetzlaff, M., Zimmerman, B., Dunn, N., Finney, N., Lewis, K., Slomoff, R., & Strutner, S. (2023). Bicalutamide Use as Antiandrogen in Trans Feminine Adults - A Safety Profile. <em>National Transgender Health Summit (NTHS) 2023 Symposium</em>. [<a href="https://web.archive.org/web/20240321010915/https://d1keuthy5s86c8.cloudfront.net/static/ems/upload/files/nyhs_202305_agenda_pdf_lbjyz.pdf">Event Agenda PDF</a>] [<a href="https://whova.com/embedded/session/D7SYg0LqOnCqwqXqLsWNIdaSkH1LCYZ1IG6HZi0Pc-U%3D/3000743/">Symposium Session</a>] [<a href="https://prevention.ucsf.edu/transhealth/education/nths">Symposium Abstracts/Program Book</a>]</li>
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||||
<li>Vierregger, K. S. (2023). Bicalutamide Use as Antiandrogen in Trans Feminine Adults - A Safety Profile. <em>USPATH 2023 Symposium</em>. [<a href="https://www.wpath.org/media/cms/Upcoming%20Conferences/2023/Schedules/Final%20USPATH%202023%20Scientific%20Symposium%20Main%20Program%20-%20Full%20Schedule.pdf">Symposium Schedule</a>]</li>
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<li>Warus, J. (2023). Safety of Bicalutamide as Anti-Androgenic Therapy in Gender Affirming Care for Adolescents and Young Adults: A Retrospective Chart Review. <em>USPATH 2023 Symposium</em>. [<a href="https://www.wpath.org/media/cms/Upcoming%20Conferences/2023/Schedules/Final%20USPATH%202023%20Scientific%20Symposium%20Main%20Program%20-%20Full%20Schedule.pdf">Symposium Schedule</a>]</li>
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<li>Wilde, B., Diamond, J. B., Laborda, T. J., Frank, L., O’Gorman, M. A., & Kocolas, I. (2023). Bicalutamide-Induced Hepatotoxicity in a Transgender Male-to-Female Adolescent. <em>Journal of Adolescent Health</em>, <em>74</em>(1), 202–204. [DOI:<a href="https://doi.org/10.1016/j.jadohealth.2023.08.024">10.1016/j.jadohealth.2023.08.024</a>]</li>
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</ul>]]></content><author><name>{"first_name"=>"Aly", "last_name"=>"W.", "author-link"=>"/about/#aly", "articles-link"=>"/articles-by-author/aly/"}</name></author><category term="github" /><category term="workspace" /><summary type="html"><![CDATA[Bicalutamide and its Adoption by the Medical Community for Use in Transfeminine Hormone Therapy By Aly | First published July 1, 2020 | Last modified March 20, 2024]]></summary></entry></feed>
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