[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>2024-03-29T02:48:24-07:00</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>
+<?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>2024-04-05T17:34:44-07:00</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>

transfemscience.org/feed.xml

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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>2024-03-29T02:48:24-07:00</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>
+<?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>2024-04-05T17:34:44-07:00</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>
 
 <!-- Supports up to four authors per article currently (author, author2, author3, author4) -->
 
@@ -370,7 +370,7 @@ Using the term desistence in this way does not imply anything about the identity
   <li>Wojniusz, S., Callens, N., Sütterlin, S., Andersson, S., De Schepper, J., Gies, I., Vanbesien, J., De Waele, K., Van Aken, S., Craen, M., Vögele, C., Cools, M., &amp; Haraldsen, I. R. (2016). Cognitive, Emotional, and Psychosocial Functioning of Girls Treated with Pharmacological Puberty Blockage for Idiopathic Central Precocious Puberty. <em>Frontiers in Psychology</em>, <em>7</em>, 1053. [DOI:<a href="https://doi.org/10.3389/fpsyg.2016.01053">10.3389/fpsyg.2016.01053</a>]</li>
   <li>Zaiem, F., Alahdab, F., Al Nofal, A., Murad, M. H., &amp; Javed, A. (2017). Oral Versus Transdermal Estrogen In Turner Syndrome: A Systematic Review And Meta-Analysis. <em>Endocrine Practice</em>, <em>23</em>(4), 408–421. [DOI:<a href="https://doi.org/10.4158/ep161622.or">10.4158/ep161622.or</a>]</li>
   <li>Zuger, B. (1978). Effeminate behavior present in boys from childhood: ten additional years of follow-up. <em>Comprehensive Psychiatry</em>, <em>19</em>(4), 363–369. [DOI:<a href="https://doi.org/10.1016/0010-440x(78)90019-6">10.1016/0010-440x(78)90019-6</a>]</li>
-</ul>]]></content><author><name>{&quot;first_name&quot;=&gt;&quot;Mitzi&quot;, &quot;author-link&quot;=&gt;&quot;/about/#mitzi&quot;, &quot;articles-link&quot;=&gt;&quot;/articles-by-author/mitzi/&quot;, &quot;email&quot;=&gt;&quot;mitzi@transfemscience.org&quot;}</name><email>mitzi@transfemscience.org</email></author><category term="github" /><category term="workspace" /><summary type="html"><![CDATA[A literature review examining the evidence surrounding the use of GnRH agonists, or puberty blockers, in transgender teens. (Mitzi, 2022)]]></summary></entry><entry><title type="html">An Interactive Web Simulator for Estradiol Levels with Injectable Estradiol Esters</title><link href="https://transfemscience.org/articles/injectable-e2-simulator-release/" rel="alternate" type="text/html" title="An Interactive Web Simulator for Estradiol Levels with Injectable Estradiol Esters" /><published>2021-07-16T12:00:00-07:00</published><updated>2023-04-12T00:00:00-07:00</updated><id>https://transfemscience.org/articles/injectable-e2-simulator-release</id><content type="html" xml:base="https://transfemscience.org/articles/injectable-e2-simulator-release/"><![CDATA[<h1 id="an-interactive-web-simulator-for-estradiol-levels-with-injectable-estradiol-esters">An Interactive Web Simulator for Estradiol Levels with Injectable Estradiol Esters</h1>
+</ul>]]></content><author><name>{&quot;first_name&quot;=&gt;&quot;Mitzi&quot;, &quot;author-link&quot;=&gt;&quot;/about/#mitzi&quot;, &quot;articles-link&quot;=&gt;&quot;/articles-by-author/mitzi/&quot;}</name></author><category term="github" /><category term="workspace" /><summary type="html"><![CDATA[A literature review examining the evidence surrounding the use of GnRH agonists, or puberty blockers, in transgender teens. (Mitzi, 2022)]]></summary></entry><entry><title type="html">An Interactive Web Simulator for Estradiol Levels with Injectable Estradiol Esters</title><link href="https://transfemscience.org/articles/injectable-e2-simulator-release/" rel="alternate" type="text/html" title="An Interactive Web Simulator for Estradiol Levels with Injectable Estradiol Esters" /><published>2021-07-16T12:00:00-07:00</published><updated>2023-04-12T00:00:00-07:00</updated><id>https://transfemscience.org/articles/injectable-e2-simulator-release</id><content type="html" xml:base="https://transfemscience.org/articles/injectable-e2-simulator-release/"><![CDATA[<h1 id="an-interactive-web-simulator-for-estradiol-levels-with-injectable-estradiol-esters">An Interactive Web Simulator for Estradiol Levels with Injectable Estradiol Esters</h1>
 
 <!-- Supports up to four authors per article currently (author, author2, author3, author4) -->
 
@@ -467,13 +467,13 @@ Using the term desistence in this way does not imply anything about the identity
 <ul>
   <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>
   <li>Behre, H. M., Abshagen, K., Oettel, M., Hubler, D., &amp; 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>
-</ul>]]></content><author><name>{&quot;first_name&quot;=&gt;&quot;Aly&quot;, &quot;last_name&quot;=&gt;&quot;W.&quot;, &quot;author-link&quot;=&gt;&quot;/about/#aly&quot;, &quot;articles-link&quot;=&gt;&quot;/articles-by-author/aly/&quot;}</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>
+</ul>]]></content><author><name>{&quot;first_name&quot;=&gt;&quot;Aly&quot;, &quot;last_name&quot;=&gt;&quot;W.&quot;, &quot;author-link&quot;=&gt;&quot;/about/#aly&quot;, &quot;articles-link&quot;=&gt;&quot;/articles-by-author/aly/&quot;}</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>2024-04-03T00:00:00-07:00</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>
 
 <!-- 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 July 16, 2021
-   | Last modified March 18, 2024</p>
+   | Last modified April 3, 2024</p>
 
 <h2 id="abstract--tldr">Abstract / TL;DR</h2>
 
@@ -1279,7 +1279,7 @@ Using the term desistence in this way does not imply anything about the identity
 
 <h3 id="estradiol-undecylate">Estradiol Undecylate</h3>
 
-<p>Estradiol undecylate was formerly used in the treatment of prostate cancer and in menopausal hormone therapy as well as for other estrogen therapeutic indications. However, it was discontinued many years ago and is no longer used today. Nonetheless, estradiol undecylate is of significant historical interest as an injectable estradiol preparation. A total of 3 publications and estradiol concentration–time data for 7 individual injections were identified for estradiol undecylate (Table 7).</p>
+<p>Estradiol undecylate was formerly used in the treatment of prostate cancer and in menopausal hormone therapy as well as for other estrogen therapeutic indications. However, it was discontinued many years ago and is no longer used today. Nonetheless, estradiol undecylate is of significant historical interest as an injectable estradiol preparation. A total of 4 publications and estradiol concentration–time data for 7 individual injections were identified for estradiol undecylate (Table 7).</p>
 
 <p><strong>Table 7:</strong> Studies of injectable estradiol undecylate (<a href="https://files.transfemscience.org/pdfs/docs/Injectable%20Estradiol%20Studies%20and%20Levels.xlsx">Spreadsheet</a>; <a href="https://files.transfemscience.org/pdfs/misc/Injectables%20Meta-Analysis%20Plotly%20Charts.zip">Plotly</a>):</p>
 
@@ -1479,7 +1479,7 @@ Using the term desistence in this way does not imply anything about the identity
   <li>Estradiol (unesterified) in an “aqueous” preparation (type of aqueous preparation unspecified but probably a microcrystalline aqueous suspension) (<a href="https://doi.org/10.1210/jcem-47-6-1368">Jones et al., 1978</a> [<a href="https://commons.wikimedia.org/wiki/File:Estradiol_and_testosterone_levels_with_a_single_intramuscular_injection_of_2_mg_aqueous_estradiol_in_healthy_young_men.png">Graph</a>])</li>
   <li>Estradiol (unesterified) in different <a href="https://en.wikipedia.org/wiki/Microsphere">microsphere</a> formulations (e.g., Juvenum-E) (<a href="https://doi.org/10.1016/0010-7824(94)90032-9">Garza-Flores, 1994</a> [<a href="https://archive.is/6U7aj">Graph</a>]; <a href="https://doi.org/10.5772/intechopen.82553">Espino y Sosa et al., 2019</a> [<a href="https://commons.wikimedia.org/wiki/File:Estradiol_levels_with_estradiol_and_progesterone_microspheres_by_intramuscular_injection_once_per_month_in_menopausal_women.png">Graph</a>])</li>
   <li><a href="https://en.wikipedia.org/wiki/Estradiol/progesterone">Estradiol/progesterone</a> in a <a href="https://en.wikipedia.org/wiki/Macrocrystalline">macrocrystalline</a> aqueous suspension (<a href="https://doi.org/10.1016/0010-7824(91)90105-O">Garza-Flores et al., 1991</a>)</li>
-  <li><a href="https://en.wikipedia.org/wiki/Estradiol/megestrol_acetate">Estradiol/megestrol acetate</a> in a microcrystalline aqueous suspension (Mego-E) (a lesser-known combined injectable contraceptive used in China) (<a href="http://en.cnki.com.cn/Article_en/CJFDTOTAL-SHEI198702001.htm">Yan et al., 1987</a> [<a href="https://archive.is/iyDyF">Graphs</a>])</li>
+  <li><a href="https://en.wikipedia.org/wiki/Estradiol/megestrol_acetate">Estradiol/megestrol acetate</a> in a microcrystalline aqueous suspension (Mego-E) (a lesser-known combined injectable contraceptive used in China) (<a href="https://web.archive.org/web/20221108144852/http://en.cnki.com.cn/Article_en/CJFDTOTAL-SHEI198702001.htm">Yan et al., 1987</a> [<a href="https://archive.is/iyDyF">Graphs</a>])</li>
   <li><a href="https://en.wikipedia.org/wiki/Estradiol_dipropionate">Estradiol dipropionate</a> in oil (Agofollin) (<a href="https://doi.org/10.1051/rnd:19760314">Presl et al., 1976</a> [<a href="https://commons.wikimedia.org/wiki/File:Estradiol_levels_after_a_single_intramuscular_injection_of_50_%CE%BCg_per_kg_estradiol_dipropionate_in_pubertal_girls.png">Graph</a>])</li>
   <li><a href="https://en.wikipedia.org/wiki/Estradiol_benzoate/estradiol_phenylpropionate">Estradiol benzoate/estradiol phenylpropionate</a> in oil (Dimenformon Prolongatum) (<a href="https://doi.org/10.1016/0378-5122(80)90060-2">Rauramo et al., 1980</a>; <a href="https://doi.org/10.1016/0378-5122(81)90010-4">Rauramo, Punnonen, &amp; Grönroos, 1981</a>)</li>
   <li><a href="https://en.wikipedia.org/wiki/Estradiol_benzoate/estradiol_phenylpropionate/testosterone_propionate/testosterone_phenylpropionate/testosterone_isocaproate">Estradiol benzoate/estradiol phenylpropionate/testosterone propionate/testosterone phenylpropionate/testosterone isocaproate</a> in oil (Estandron Prolongatum) (<a href="https://doi.org/10.1080/17843286.1975.11716973">Vermeulen, 1975</a>)</li>
@@ -1866,7 +1866,7 @@ Using the term desistence in this way does not imply anything about the identity
 
 <p>With the preceding concerns about the doses and intervals of injectable estradiol preparations recommended by transgender care guidelines considered, the question of how these recommendations were determined arises. Unfortunately, current guidelines do not generally describe how they arrived at their recommendations nor do they usually cite sources to support them. It is notable that the UCSF guidelines recommend doses and intervals for injectable estradiol preparations that are nearly identical to those advised by <a href="https://en.wikipedia.org/wiki/Christian_Hamburger">Christian Hamburger</a> and <a href="https://en.wikipedia.org/wiki/Harry_Benjamin">Harry Benjamin</a> in the late 1960s in the first medical textbook on transgender people (<a href="https://scholar.google.com/scholar?cluster=17287240145299798098">Hamburger &amp; Benjamin, 1969</a>). These authors recommended a dose of 10–40 mg/2 weeks for estradiol valerate and of 2–5 mg/2 weeks for estradiol cypionate (although Benjamin additionally stated that after 4–8 months, the same doses could be used at a longer injection interval of once every 4 weeks). These recommendations were notably made before estradiol blood tests became practicably available and were prior to the advent of modern pharmacokinetic studies. Hence, the recommendations for at least these guidelines appear to be based mainly on past expert opinion and long-standing historical precedent rather than on pharmacokinetic or clinical data. The same is likely to also be true for most other guidelines. High doses with certain injectable estradiol preparations (namely estradiol valerate) were probably originally employed for the purpose of achieving longer durations and more convenient injection intervals. This was notably prior to the risks of excessive estrogenic exposure like blood clots becoming known, and these doses may simply have never been revised.</p>
 
-<p>The reasons that dose recommendations for injectable estradiol in transfeminine people have remained as they have for so long may be related to several factors. These include (1) a long-standing lack of research and funding in transgender health; (2) injectable estradiol not being widely available or as commonly used as other forms of estradiol; and (3) many clinicians only testing estradiol levels at trough (right before the next injection) with injectable estradiol preparations (e.g., <a href="https://doi.org/10.1055/s-0030-1255074">Mueller et al., 2011</a>; <a href="https://doi.org/10.4158/EP-2020-0414">Chantrapanichkul et al., 2021</a>; <a href="https://doi.org/10.1089/lgbt.2020.0249">Cirrincione et al., 2021</a>). The latter point is noteworthy as trough levels only describe the lowest point of the estradiol concentration–time curve with injectable estradiol preparations, and can give a very misleading impression of average or total estradiol exposure. In any case, the very high estradiol levels with currently recommended doses of injectable estradiol forms for transfeminine people have not gone unnoticed in the literature (e.g., <a href="https://doi.org/10.1159/000087751">Gooren, 2005</a>; <a href="https://doi.org/10.1001/jama.2012.165234">Spack, 2013</a>; <a href="https://books.google.com/books?id=EuB_AwAAQBAJ&amp;pg=PA241">Deutsch, 2014</a>; <a href="https://doi.org/10.1530/EJE-21-0059">Glintborg et al., 2021</a>; <a href="https://doi.org/10.3390/ijerph182312640">Tassinari &amp; Maranghi, 2021</a>; <a href="https://doi.org/10.1016/j.tips.2022.03.006">Le, Huang, &amp; Cirrincione, 2022</a>). Additionally, clinical studies in transfeminine people have reported high to very high estradiol levels with typical clinical doses of injectable estradiol (e.g., <a href="https://doi.org/10.1530/EJE-09-0265">Kronawitter et al., 2009</a> [<a href="https://archive.is/k2HTe">Table</a>]; <a href="https://doi.org/10.1055/s-0030-1255074">Mueller et al., 2011</a> [<a href="https://archive.is/1X4Co">Table</a>]; <a href="https://doi.org/10.1111/j.1447-0756.2011.01815.x">Sharula et al., 2012</a> [<a href="https://files.transfemscience.org/pdfs/docs/Sharula%20et%20al.%20(2012)%20Tables%201%20and%202%20Clinical%20Features%20+%20Laboratory%20Data.pdf">Data</a>]; <a href="https://doi.org/10.1089/trgh.2016.0016">Nelson et al., 2016</a> [<a href="https://archive.is/MlUU5">Table</a>]; <a href="https://doi.org/10.1016/j.fertnstert.2020.08.277">LaBudde, Craig, &amp; Spratt, 2020</a>; <a href="https://doi.org/10.4158/EP-2020-0414">Chantrapanichkul et al., 2021</a> [<a href="https://archive.is/arQvz">Table</a>]; <a href="https://doi.org/10.1089/lgbt.2020.0249">Cirrincione et al., 2021</a> [<a href="https://archive.is/Gk8Y5">Table</a>]).</p>
+<p>The reasons that dose recommendations for injectable estradiol in transfeminine people have remained as they have for so long may be related to several factors. These include (1) a long-standing lack of research and funding in transgender health; (2) injectable estradiol not being widely available or as commonly used as other forms of estradiol; and (3) many clinicians only testing estradiol levels at trough (right before the next injection) with injectable estradiol preparations (e.g., <a href="https://doi.org/10.1055/s-0030-1255074">Mueller et al., 2011</a>; <a href="https://doi.org/10.4158/EP-2020-0414">Chantrapanichkul et al., 2021</a>; <a href="https://doi.org/10.1089/lgbt.2020.0249">Cirrincione et al., 2021</a>). The latter point is noteworthy as trough levels only describe the lowest point of the estradiol concentration–time curve with injectable estradiol preparations, and can give a very misleading impression of average or total estradiol exposure. In any case, the very high estradiol levels with currently recommended doses of injectable estradiol forms for transfeminine people have not gone unnoticed in the literature (e.g., <a href="https://doi.org/10.1159/000087751">Gooren, 2005</a>; <a href="https://doi.org/10.1001/jama.2012.165234">Spack, 2013</a>; <a href="https://books.google.com/books?id=EuB_AwAAQBAJ&amp;pg=PA241">Deutsch, 2014</a>; <a href="https://doi.org/10.1530/EJE-21-0059">Glintborg et al., 2021</a>; <a href="https://doi.org/10.3390/ijerph182312640">Tassinari &amp; Maranghi, 2021</a>; <a href="https://doi.org/10.1016/j.tips.2022.03.006">Le, Huang, &amp; Cirrincione, 2022</a>). Additionally, clinical studies in transfeminine people have reported high to very high estradiol levels with typical clinical doses of injectable estradiol (e.g., <a href="https://doi.org/10.1530/EJE-09-0265">Kronawitter et al., 2009</a> [<a href="https://archive.is/k2HTe">Table</a>]; <a href="https://doi.org/10.1055/s-0030-1255074">Mueller et al., 2011</a> [<a href="https://archive.is/cXyD5">Table</a>]; <a href="https://doi.org/10.1111/j.1447-0756.2011.01815.x">Sharula et al., 2012</a> [<a href="https://files.transfemscience.org/pdfs/docs/Sharula%20et%20al.%20(2012)%20Tables%201%20and%202%20Clinical%20Features%20+%20Laboratory%20Data.pdf">Data</a>]; <a href="https://doi.org/10.1089/trgh.2016.0016">Nelson et al., 2016</a> [<a href="https://archive.is/MlUU5">Table</a>]; <a href="https://doi.org/10.1016/j.fertnstert.2020.08.277">LaBudde, Craig, &amp; Spratt, 2020</a>; <a href="https://doi.org/10.4158/EP-2020-0414">Chantrapanichkul et al., 2021</a> [<a href="https://archive.is/arQvz">Table</a>]; <a href="https://doi.org/10.1089/lgbt.2020.0249">Cirrincione et al., 2021</a> [<a href="https://archive.is/Gk8Y5">Table</a>]).</p>
 
 <p>Among the surveyed guidelines for transgender hormone therapy, only the UCSF guidelines (<a href="https://transcare.ucsf.edu/guidelines/feminizing-hormone-therapy">Deutsch, 2016b</a>) and the <a href="https://sherbourne.on.ca/">Sherbourne Health</a>/<a href="https://www.rainbowhealthontario.ca/">Rainbow Health Ontario</a> guidelines (<a href="https://www.rainbowhealthontario.ca/product/4th-edition-sherbournes-guidelines-for-gender-affirming-primary-care-with-trans-and-non-binary-patients/">Bourns, 2019</a>) referenced pharmacokinetic literature in their discussion of injectable estradiol. The specific publications cited by these guidelines were <a href="https://doi.org/10.1016/0378-5122(82)90064-0">Düsterberg &amp; Nishino (1982)</a>, <a href="https://doi.org/10.1016/j.contraception.2011.03.014">Sierra-Ramírez et al. (2011)</a>, and <a href="https://doi.org/10.1016/j.contraception.2012.11.010">Thurman et al. (2013)</a>. Although it is favorable to see guidelines considering published pharmacokinetic data for informing use of these preparations, there are a few concerns about the studies that were cited. <a href="https://doi.org/10.1016/0378-5122(82)90064-0">Düsterberg &amp; Nishino (1982)</a> in its study of injectable estradiol valerate had a very small sample size (n=2), and this study was excluded as an outlier in the present meta-analysis due to unusually high estradiol levels. The findings of <a href="https://doi.org/10.1016/0378-5122(82)90064-0">Düsterberg &amp; Nishino (1982)</a> also do not seem to have actually been used to guide dosing recommendations in the case of the UCSF guidelines, since if this were the case, the recommended doses should have been much lower. On the other hand, <a href="https://www.rainbowhealthontario.ca/product/4th-edition-sherbournes-guidelines-for-gender-affirming-primary-care-with-trans-and-non-binary-patients/">Bourns (2019)</a> cited the same study and recommended injectable estradiol valerate at doses of 3–4 mg/week or 6–8 mg/2 weeks. These doses are well below those recommended by other transgender care guidelines and appear to be more appropriate for use in transfeminine people in light of the present meta-analysis. <a href="https://doi.org/10.1016/j.contraception.2011.03.014">Sierra-Ramírez et al. (2011)</a> and <a href="https://doi.org/10.1016/j.contraception.2012.11.010">Thurman et al. (2013)</a>, although better-quality studies than <a href="https://doi.org/10.1016/0378-5122(82)90064-0">Düsterberg &amp; Nishino (1982)</a>, described injectable estradiol cypionate suspension rather than estradiol cypionate in oil. The oil-based version of estradiol cypionate is the form normally used in transfeminine hormone therapy, and there are important differences between these estradiol cypionate preparations such that pharmacokinetic studies for the suspension can’t necessarily be generalized to the oil solution. These preparations do in any case produce similar total estradiol levels however and hence doses should be comparable for them.</p>
 
@@ -1898,7 +1898,7 @@ Using the term desistence in this way does not imply anything about the identity
 
 <h3 id="update-1-wpath-soc8-guidelines">Update 1: WPATH SOC8 Guidelines</h3>
 
-<p>In September 2022, the <a href="https://en.wikipedia.org/wiki/World_Professional_Association_for_Transgender_Health">World Professional Association for Transgender Health</a> (WPATH) <a href="https://en.wikipedia.org/wiki/Standards_of_Care_for_the_Health_of_Transgender_and_Gender_Diverse_People">Standards of Care for the Health of Transgender and Gender Diverse People</a> Version 8 (SOC8) were published and made recommendations on transgender hormone therapy for the first time (<a href="https://doi.org/10.1080/26895269.2022.2100644">Coleman et al., 2022</a>). These guidelines are among the most highly regarded and consulted transgender care guidelines that exist. In terms of the recommended doses of hormonal medications for transgender people, the WPATH SOC8 appear to have largely copied the <a href="https://en.wikipedia.org/wiki/Endocrine_Society">Endocrine Society’s</a> 2017 guidelines on transgender hormone therapy (<a href="https://doi.org/10.1210/jc.2017-01658">Hembree et al., 2017</a>). More specifically, in the case of injectable estradiol preparations for transfeminine people, doses of 5–30 mg/2 weeks or 2–10 mg/week estradiol valerate or estradiol cypionate were recommended. There was no discussion of injectable estradiol in the guidelines besides the preceding doses and intervals being included in a table, and no literature citations were included to support these doses. As described in the present work, these recommendations include doses and intervals that appear to be highly excessive, too widely spaced, and likely unsafe. As such, major transgender care guidelines unfortunately continue to make uncited recommendations for injectable estradiol in transfeminine people that are out of step with insights available from abundant published pharmacokinetic data and are likely inadvisable, with the possibility of substantial safety risks.</p>
+<p>In September 2022, the <a href="https://en.wikipedia.org/wiki/World_Professional_Association_for_Transgender_Health">World Professional Association for Transgender Health</a> (WPATH) <a href="https://en.wikipedia.org/wiki/Standards_of_Care_for_the_Health_of_Transgender_and_Gender_Diverse_People">Standards of Care for the Health of Transgender and Gender Diverse People</a> Version 8 (SOC8) were published and made recommendations on transgender hormone therapy for the first time (<a href="https://doi.org/10.1080/26895269.2022.2100644">Coleman et al., 2022</a>). These guidelines are among the most highly regarded and consulted transgender care guidelines. In terms of the recommended doses of hormonal medications for transgender people, the WPATH SOC8 appear to have largely copied the <a href="https://en.wikipedia.org/wiki/Endocrine_Society">Endocrine Society’s</a> 2017 guidelines on transgender hormone therapy (<a href="https://doi.org/10.1210/jc.2017-01658">Hembree et al., 2017</a>). More specifically, in the case of injectable estradiol preparations for transfeminine people, doses of 5–30 mg/2 weeks or 2–10 mg/week estradiol valerate or estradiol cypionate were recommended. There was no discussion of injectable estradiol in the guidelines besides the preceding doses and intervals being included in a table, and no literature citations were included to support these doses. As described in the present work, these recommendations include doses and intervals that appear to be highly excessive, too widely spaced, and are likely unsafe. As such, major transgender care guidelines unfortunately continue to make uncited recommendations for injectable estradiol in transfeminine people that are out of step with insights available from abundant published pharmacokinetic data. These recommendations are likely inadvisable, with the possibility of substantial safety risks.</p>
 
 <h3 id="update-2-literature-mentions">Update 2: Literature Mentions</h3>
 
@@ -2111,7 +2111,7 @@ Using the term desistence in this way does not imply anything about the identity
   <li>Messinis, I. E., &amp; Templeton, A. (1987). Effect of high dose exogenous oestrogen on midcycle luteinizing hormone surge in human spontaneous cycles. <em>Clinical Endocrinology</em>, <em>27</em>(4), 453–459. [DOI:<a href="https://doi.org/10.1111/j.1365-2265.1987.tb01173.x">10.1111/j.1365-2265.1987.tb01173.x</a>]</li>
   <li>Messinis, I. E., &amp; Templeton, A. A. (1987). Disparate effects of endogenous and exogenous oestradiol on luteal phase function in women. <em>Reproduction</em>, <em>79</em>(2), 549–554. [DOI:<a href="https://doi.org/10.1530/jrf.0.0790549">10.1530/jrf.0.0790549</a>]</li>
   <li>Minto, C. F., Howe, C., Wishart, S., Conway, A. J., &amp; Handelsman, D. J. (1997). Pharmacokinetics and pharmacodynamics of nandrolone esters in oil vehicle: effects of ester, injection site and injection volume. <em>Journal of Pharmacology and Experimental Therapeutics</em>, <em>281</em>(1), 93–102. [<a href="https://jpet.aspetjournals.org/content/281/1/93.short">URL</a>]</li>
-  <li>Mueller, A., Zollver, H., Kronawitter, D., Oppelt, P. G., Claassen, T., Hoffmann, I., Beckmann, M. W., &amp; Dittrich, R. (2011). Body composition and bone mineral density in male-to-female transsexuals during cross-sex hormone therapy using gonadotrophin-releasing hormone agonist. <em>Experimental and Clinical Endocrinology &amp; Diabetes</em>, <em>119</em>(2), 95–100. [DOI:<a href="https://doi.org/10.1055/s-0030-1255074">10.1055/s-0030-1255074</a>] [<a href="https://archive.is/1X4Co">Table</a>]</li>
+  <li>Mueller, A., Zollver, H., Kronawitter, D., Oppelt, P. G., Claassen, T., Hoffmann, I., Beckmann, M. W., &amp; Dittrich, R. (2011). Body composition and bone mineral density in male-to-female transsexuals during cross-sex hormone therapy using gonadotrophin-releasing hormone agonist. <em>Experimental and Clinical Endocrinology &amp; Diabetes</em>, <em>119</em>(2), 95–100. [DOI:<a href="https://doi.org/10.1055/s-0030-1255074">10.1055/s-0030-1255074</a>] [<a href="https://archive.is/cXyD5">Table</a>]</li>
   <li>Newton, J. R., d’Arcangues, C., &amp; Hall, P. E. (1994). A review of ‘once-a-month’ combined injectable contraceptives. <em>Journal of Obstetrics and Gynaecology</em>, <em>14</em>(Suppl 1), S1–S34. [DOI:<a href="https://doi.org/10.3109/01443619409027641">10.3109/01443619409027641</a>]</li>
   <li>Nelson, M. D., Szczepaniak, L. S., Wei, J., Szczepaniak, E., Sánchez, F. J., Vilain, E., Stern, J. H., Bergman, R. N., Bairey Merz, C. N., &amp; Clegg, D. J. (2016). Transwomen and the Metabolic Syndrome: Is Orchiectomy Protective? <em>Transgender Health</em>, <em>1</em>(1), 165–171. [DOI:<a href="https://doi.org/10.1089/trgh.2016.0016">10.1089/trgh.2016.0016</a>] [<a href="https://archive.is/MlUU5">Table</a>]</li>
   <li>Nieschlag, E., &amp; Behre, H. M. (2010). Testosterone therapy. In Nieschlag, E., Behre, H. M., &amp; Nieschlag, S. (Eds.). <em>Andrology</em> (pp. 437–455). Berlin/Heidelberg: Springer. [DOI:<a href="https://doi.org/10.1007/978-3-540-78355-8_21">10.1007/978-3-540-78355-8_21</a>] [<a href="https://web.archive.org/web/20210824082448if_/http://ssu.ac.ir/cms/fileadmin/user_upload/vonline/etiad/manabeamoozeshi/Andrology_Part_3.pdf">PDF</a>]</li>
@@ -2172,7 +2172,7 @@ Using the term desistence in this way does not imply anything about the identity
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   <li>Varangot, J., &amp; Cedard, L. (1957). Modifications des Œstrogènes Sanguins Après Administration Intramusculaire de Benzoate d’Œstradiol. [Changes in Serum Estrogens After Intramuscular Administration of Estradiol Benzoate.] <em>Comptes Rendus des Séances de la Société de Biologie et de ses Filiales</em>, <em>151</em>(10), 1707–1712. [<a href="https://scholar.google.com/scholar?cluster=4116513909135850261">Google Scholar 1</a>] [<a href="https://scholar.google.com/scholar?cluster=17882711728421914146">Google Scholar 2</a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/13547587/">PubMed</a>] [<a href="https://files.transfemscience.org/pdfs/Varangot%20&amp;%20Cedard%20(1957)%20-%20Modifications%20des%20%C5%92strog%C3%A8nes%20Sanguins%20Apr%C3%A8s%20Administration%20Intramusculaire%20de%20Benzoate%20d'%C5%92stradiol%20[...].pdf">PDF</a>] [<a href="https://files.transfemscience.org/pdfs/translations/Varangot%20&amp;%20Cedard%20(1957)%20-%20Modifications%20des%20Œstrogènes%20Sanguins%20Après%20Administration%20Intramusculaire%20de%20Benzoate%20d'Œstradiol.pdf">Translation</a>]</li>
   <li>Vermeulen, A. (1975). Longacting steroid preparations. <em>Acta Clinica Belgica</em>, <em>30</em>(1), 48–55. [DOI:<a href="https://doi.org/10.1080/17843286.1975.11716973">10.1080/17843286.1975.11716973</a>]</li>
-  <li>Vermeulen, A. (1977). Transport and Distribution of Androgens at Different Ages. In Martini, L., &amp; Motta, M. (Eds.). <em>Androgens and Antiandrogens</em> (pp. 53–65). New York: Raven Press. [<a href="https://scholar.google.com/scholar?cluster=5963522046259984312">Google Scholar</a>] [<a href="https://books.google.com/books?id=LQdrAAAAMAAJ">Google Books</a>] [<a href="https://www.worldcat.org/title/androgens-and-antiandrogens/oclc/925036459">WorldCat</a>]</li>
+  <li>Vermeulen, A. (1977). Transport and Distribution of Androgens at Different Ages. In Martini, L., &amp; Motta, M. (Eds.). <em>Androgens and Antiandrogens</em> (pp. 53–65). New York: Raven Press. [<a href="https://scholar.google.com/scholar?cluster=5963522046259984312">Google Scholar</a>] [<a href="https://books.google.com/books?id=LQdrAAAAMAAJ&amp;q=%22Transport+and+Distribution+of+Androgens+at+Different+Ages%22+vermeulen">Google Books</a>] [<a href="https://openlibrary.org/works/OL6908523W/">OpenLibrary</a>] [<a href="https://www.worldcat.org/title/androgens-and-antiandrogens/oclc/925036459">WorldCat</a>] [<a href="https://archive.org/details/androgensantiand0000inte/page/59/">Archive.org</a>] [<a href="https://archive.is/1BCM4">Excerpt</a>]</li>
   <li>Vhora, I., Bardoliwala, D., Ranamalla, S. R., &amp; Javia, A. (2019). Parenteral controlled and prolonged drug delivery systems: therapeutic needs and formulation strategies. In Misra A., &amp; Shahiwala, A. (Eds.). <em>Novel Drug Delivery Technologies</em> (pp. 183–260). Singapore: Springer. [DOI:<a href="https://doi.org/10.1007/978-981-13-3642-3_7">10.1007/978-981-13-3642-3_7</a>]</li>
   <li>Vizziello, G., D’Amato, G., Trentadue, R., &amp; Fanizza, G. (1993). Studio dinamico del blocco ipofisario indotto dalla triptorelina, mediante test all’estradiolo benzoato. [Estradiol benzoate test in the study of pituitary block induced by triptorelin.] <em>Minerva Ginecologica</em>, <em>45</em>(4), 185–189. [<a href="https://scholar.google.com/scholar?cluster=6929403185613656842">Google Scholar</a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/8506068/">PubMed</a>] [<a href="https://files.transfemscience.org/pdfs/Vizziello%20et%20al.%20(1993)%20-%20Studio%20Dinamico%20del%20Blocco%20Ipofisario%20Indotto%20Dalla%20Triptorelina,%20Mediante%20Test%20All'estradiolo%20Benzoato.pdf">PDF</a>] [<a href="https://files.transfemscience.org/pdfs/translations/Vizziello%20et%20al.%20(1993)%20-%20Studio%20dinamico%20del%20blocco%20ipofisario%20indotto%20dalla%20triptorelina,%20mediante%20test%20all’estradiolo%20benzoato.pdf">Translation</a>]</li>
   <li>Wagner, J. G. (1993). <em>Pharmacokinetics for the Pharmaceutical Scientist.</em> Lancaster/Basel: Technomic. [DOI:<a href="https://doi.org/10.1201/9780203743652">10.1201/9780203743652</a>] [<a href="https://books.google.com/books?id=gMuCDwAAQBAJ">Google Books</a>]</li>
@@ -2180,17 +2180,17 @@ Using the term desistence in this way does not imply anything about the identity
   <li>White, M. C., Rosenstock, J., Anapliotou, M., Mashiter, K., &amp; Joplin, G. F. (1981). Heterogeneity of prolactin responses to oestradiol benzoate in women with prolactinomas. <em>The Lancet</em>, <em>317</em>(8235), 1394–1396. [DOI:<a href="https://doi.org/10.1016/S0140-6736(81)92571-X">10.1016/S0140-6736(81)92571-X</a>]</li>
   <li>Wiemeyer, J. C., Fernandez, M., Moguilevsky, J. A., &amp; Sagasta, C. L. (1986). Pharmacokinetic Studies of Estradiol Enantate in Menopausic Women. <em>Arzneimittel-Forschung</em>, <em>36</em>(11), 1674–1677. [<a href="https://scholar.google.com/scholar?cluster=7439774806423569110">Google Scholar</a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/3814225/">PubMed</a>] [<a href="https://files.transfemscience.org/pdfs/Wiemeyer%20et%20al.%20(1986)%20-%20Pharmacokinetic%20Studies%20of%20Estradiol%20Enantate%20in%20Menopausic%20Women.pdf">PDF</a>]</li>
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-</ul>]]></content><author><name>{&quot;first_name&quot;=&gt;&quot;Aly&quot;, &quot;last_name&quot;=&gt;&quot;W.&quot;, &quot;author-link&quot;=&gt;&quot;/about/#aly&quot;, &quot;articles-link&quot;=&gt;&quot;/articles-by-author/aly/&quot;}</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>
+</ul>]]></content><author><name>{&quot;first_name&quot;=&gt;&quot;Aly&quot;, &quot;last_name&quot;=&gt;&quot;W.&quot;, &quot;author-link&quot;=&gt;&quot;/about/#aly&quot;, &quot;articles-link&quot;=&gt;&quot;/articles-by-author/aly/&quot;}</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 April 3, 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>2024-03-30T00:00:00-07:00</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>
 
 <!-- Supports up to four authors per article currently (author, author2, author3, author4) -->
 
 <p>By 
 <!-- First author --><a href="/about/#sam">Sam</a><!-- Second author --><!-- Third author --><!-- Fourth author --> | First published June 11, 2021
-   | Last modified September 6, 2021</p>
+   | Last modified March 30, 2024</p>
 
 <h2 id="abstract--tldr">Abstract / TL;DR</h2>
 
@@ -2343,6 +2343,30 @@ Using the term desistence in this way does not imply anything about the identity
 
 <p>Taken together, although much more research is clearly needed to properly characterise the route, sublingual estradiol may have a number of advantageous properties and may be a useful alternative to oral estradiol in transfeminine hormone therapy.</p>
 
+<h2 id="updates">Updates</h2>
+
+<h3 id="update-1-new-sublingual-estradiol-studies-added-by-aly">Update 1: New Sublingual Estradiol Studies (Added By Aly)</h3>
+
+<p>Since this article was first published, the following new relevant studies and papers on sublingual estradiol in transfeminine people have been published:</p>
+
+<ul>
+  <li>Doll, E., Gunsolus, I., Thorgerson, A., Tangpricha, V., Lamberton, N., &amp; Sarvaideo, J. L. (2022). Pharmacokinetics of Sublingual Versus Oral Estradiol in Transgender Women. <em>Endocrine Practice</em>, <em>28</em>(3), 237–242. [DOI:<a href="https://doi.org/10.1016/j.eprac.2021.11.081">10.1016/j.eprac.2021.11.081</a>]
+    <ul>
+      <li>Safer, J. D. (2022). Are the Pharmacokinetics of Sublingual Estradiol Superior or Inferior to Those of Oral Estradiol? <em>Endocrine Practice</em>, <em>28</em>(3), 351–352. [DOI:<a href="https://doi.org/10.1016/j.eprac.2021.12.018">10.1016/j.eprac.2021.12.018</a>]</li>
+      <li>Sarvaideo, J., Doll, E., &amp; Tangpricha, V. (2022). More Studies Are Needed to Establish the Safety and Efficacy of Sublingual Estradiol in Transgender Women. <em>Endocrine Practice</em>, <em>28</em>(3), 353–354. [DOI:<a href="https://doi.org/10.1016/j.eprac.2022.01.004">10.1016/j.eprac.2022.01.004</a>]</li>
+    </ul>
+  </li>
+  <li>Cortez, S., Moog, D., Lewis, C., Williams, K., Herrick, C., Fields, M., Gray, T., Guo, Z., Nicol, G., &amp; Baranski, T. (2023). Effectiveness and Safety of Different Estradiol Regimens in Transgender Women (TREAT Study): Protocol for a Randomized Controlled Trial. <em>JMIR Research Protocols</em>, <em>12</em>, e53092. [DOI:<a href="https://doi.org/10.2196/53092">10.2196/53092</a>]</li>
+  <li>Jalal, E., &amp; Baldwin, C. (2023). Supratherapeutic Estrogen Levels in Transgender Women Likely From Sublingual Estradiol. <em>Journal of the Endocrine Society</em>, <em>7</em>(Suppl 1) [<em>ENDO 2023 Abstracts Annual Meeting of the Endocrine Society</em>], A1095–A1096 (abstract no. SAT391/bvad114.2062). [DOI:<a href="https://doi.org/10.1210/jendso/bvad114.2062">10.1210/jendso/bvad114.2062</a>] [<a href="https://academic.oup.com/jes/article-pdf/7/Supplement_1/bvad114.2062/51903510/bvad114.2062.pdf">PDF</a>]</li>
+  <li>Yaish, I., Gindis, G., Greenman, Y., Moshe, Y., Arbiv, M., Buch, A., Sofer, Y., Shefer, G., &amp; Tordjman, K. (2023). Sublingual Estradiol Offers No Apparent Advantage Over Combined Oral Estradiol and Cyproterone Acetate for Gender-Affirming Hormone Therapy of Treatment-Naive Trans Women: Results of a Prospective Pilot Study. <em>Transgender Health</em>, <em>8</em>(6), 485–493. [DOI:<a href="https://doi.org/10.1089/trgh.2023.0022">10.1089/trgh.2023.0022</a>]
+    <ul>
+      <li>Gindis, G., Yaish, I., Greenman, Y., Moshe, Y., Arbiv, M., Buch, A., Sofer, Y., Shefer, G., &amp; Tordjman, K. (May 2023). Sublingual estradiol only, offers no apparent advantage over combined oral estradiol and cyproterone acetate, for Gender Affirming Hormone Therapy (GAHT) of treatment-naive transwomen: Results of a prospective pilot study. <em>Endocrine Abstracts</em>, <em>90</em> [<em>25th European Congress of Endocrinology 2023, 13–16 May 2023, Istanbul, Turkey</em>], 274–274 (abstract no. P182). [DOI:<a href="https://doi.org/10.1530/endoabs.90.p182">10.1530/endoabs.90.p182</a>] [<a href="https://www.endocrine-abstracts.org/media/upujresq/ece2023abstractbook.pdf#page=274">PDF</a>]</li>
+      <li>Yaish, I., Gindis, G., Greenman, Y., Shefer, G., Buch, A., Arbiv, M., Moshe, Y., Sofer, Y., &amp; Tordjman, K. M. (October 2023). Sublingual Estradiol Only, Compared To Combined Oral Estradiol And Cyproterone Acetate,Offers No Apparent Advantage For Gender Affirming Hormone Therapy (GHAT), In Treatment Naïve Transwomen: Results Of A Prospective Pilot Study. <em>Journal of the Endocrine Society</em>, <em>7</em>(Suppl 1) [<em>ENDO 2023 Abstracts Annual Meeting of the Endocrine Society</em>], A1104–A1105 (abstract no. SAT409/bvad114.2080). [DOI:<a href="https://doi.org/10.1210/jendso/bvad114.2080">10.1210/jendso/bvad114.2080</a>] [<a href="https://academic.oup.com/jes/article-pdf/7/Supplement_1/bvad114.2080/51899408/bvad114.2080.pdf">PDF</a>]</li>
+    </ul>
+  </li>
+  <li>Kariyawasam, N. M., Ahmad, T., Sarma, S., &amp; Fung, R. (2024). Comparison of Estrone/Estradiol Ratio and Levels in Transfeminine Individuals on Different Routes of Estradiol. <em>Transgender Health</em>, online ahead of print. [DOI:<a href="https://doi.org/10.1089/trgh.2023.0138">10.1089/trgh.2023.0138</a>]</li>
+</ul>
+
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+  <li>Gindis, G., Yaish, I., Greenman, Y., Moshe, Y., Arbiv, M., Buch, A., Sofer, Y., Shefer, G., &amp; Tordjman, K. (May 2023). Sublingual estradiol only, offers no apparent advantage over combined oral estradiol and cyproterone acetate, for Gender Affirming Hormone Therapy (GAHT) of treatment-naive transwomen: Results of a prospective pilot study. <em>Endocrine Abstracts</em>, <em>90</em> [<em>25th European Congress of Endocrinology 2023, 13–16 May 2023, Istanbul, Turkey</em>], 274–274 (abstract no. P182). [DOI:<a href="https://doi.org/10.1530/endoabs.90.p182">10.1530/endoabs.90.p182</a>] [<a href="https://www.endocrine-abstracts.org/media/upujresq/ece2023abstractbook.pdf#page=274">PDF</a>]</li>
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@@ -2390,6 +2419,8 @@ Using the term desistence in this way does not imply anything about the identity
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   <li>Rosenfield, R. L., Devine, N., Hunold, J. J., Mauras, N., Moshang Jr, T., &amp; Root, A. W. (2005). Salutary effects of combining early very low-dose systemic estradiol with growth hormone therapy in girls with Turner syndrome. <em>The Journal of Clinical Endocrinology &amp; Metabolism</em>, <em>90</em>(12), 6424–6430. [DOI:<a href="https://doi.org/10.1210/jc.2005-1081">10.1210/jc.2005-1081</a>]</li>
   <li>Rovinski, D., Ramos, R. B., Fighera, T. M., Casanova, G. K., &amp; Spritzer, P. M. (2018). Risk of venous thromboembolism events in postmenopausal women using oral versus non-oral hormone therapy: a systematic review and meta-analysis. <em>Thrombosis Research</em>, <em>168</em>, 83–95. [DOI:<a href="https://doi.org/10.1016/j.thromres.2018.06.014">10.1016/j.thromres.2018.06.014</a>]</li>
+  <li>Safer, J. D. (2022). Are the Pharmacokinetics of Sublingual Estradiol Superior or Inferior to Those of Oral Estradiol? <em>Endocrine Practice</em>, <em>28</em>(3), 351–352. [DOI:<a href="https://doi.org/10.1016/j.eprac.2021.12.018">10.1016/j.eprac.2021.12.018</a>]</li>
+  <li>Sarvaideo, J., Doll, E., &amp; Tangpricha, V. (2022). More Studies Are Needed to Establish the Safety and Efficacy of Sublingual Estradiol in Transgender Women. <em>Endocrine Practice</em>, <em>28</em>(3), 353–354. [DOI:<a href="https://doi.org/10.1016/j.eprac.2022.01.004">10.1016/j.eprac.2022.01.004</a>]</li>
   <li>Sciarra, A., Gentile, V., Cattarino, S., Gentilucci, A., Alfarone, A., D’Eramo, G., &amp; Salciccia, S. (2015). Oral ethinylestradiol in castration‐resistant prostate cancer: a 10‐year experience. <em>International Journal of Urology</em>, <em>22</em>(1), 98–103. [DOI:<a href="https://doi.org/10.1111/iju.12613">10.1111/iju.12613</a>]</li>
   <li>Serhal, P., &amp; Craft, I. (1989). Oocyte donation in 61 patients. <em>The Lancet</em>, <em>333</em>(8648), 1185–1187. [DOI:<a href="https://doi.org/10.1016/S0140-6736(89)92762-1">10.1016/S0140-6736(89)92762-1</a>]</li>
   <li>Serhal, P. (1990). Oocyte donation and surrogacy. <em>British Medical Bulletin</em>, <em>46</em>(3), 796–812. [DOI:<a href="https://doi.org/10.1093/oxfordjournals.bmb.a072432">10.1093/oxfordjournals.bmb.a072432</a>]</li>
@@ -2404,7 +2435,9 @@ Using the term desistence in this way does not imply anything about the identity
   <li>Wiegratz, I., Fink, T., Rohr, U. D., Lang, E., Leukel, P., &amp; 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>
   <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., &amp; 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>
   <li>Wren, B. G., Day, R. O., McLachlan, A. J., &amp; 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>
-</ul>]]></content><author><name>{&quot;first_name&quot;=&gt;&quot;Sam&quot;, &quot;last_name&quot;=&gt;&quot;S.&quot;, &quot;author-link&quot;=&gt;&quot;/about/#sam&quot;, &quot;articles-link&quot;=&gt;&quot;/articles-by-author/sam/&quot;}</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>
+  <li>Yaish, I., Gindis, G., Greenman, Y., Moshe, Y., Arbiv, M., Buch, A., Sofer, Y., Shefer, G., &amp; Tordjman, K. (2023). Sublingual Estradiol Offers No Apparent Advantage Over Combined Oral Estradiol and Cyproterone Acetate for Gender-Affirming Hormone Therapy of Treatment-Naive Trans Women: Results of a Prospective Pilot Study. <em>Transgender Health</em>, <em>8</em>(6), 485–493. [DOI:<a href="https://doi.org/10.1089/trgh.2023.0022">10.1089/trgh.2023.0022</a>]</li>
+  <li>Yaish, I., Gindis, G., Greenman, Y., Shefer, G., Buch, A., Arbiv, M., Moshe, Y., Sofer, Y., &amp; Tordjman, K. M. (2023). Sublingual Estradiol Only, Compared To Combined Oral Estradiol And Cyproterone Acetate,Offers No Apparent Advantage For Gender Affirming Hormone Therapy (GHAT), In Treatment Naïve Transwomen: Results Of A Prospective Pilot Study. <em>Journal of the Endocrine Society</em>, <em>7</em>(Suppl 1) [<em>ENDO 2023 Abstracts Annual Meeting of the Endocrine Society</em>], A1104–A1105 (abstract no. SAT409/bvad114.2080). [DOI:<a href="https://doi.org/10.1210/jendso/bvad114.2080">10.1210/jendso/bvad114.2080</a>] [<a href="https://academic.oup.com/jes/article-pdf/7/Supplement_1/bvad114.2080/51899408/bvad114.2080.pdf">PDF</a>]</li>
+</ul>]]></content><author><name>{&quot;first_name&quot;=&gt;&quot;Sam&quot;, &quot;last_name&quot;=&gt;&quot;S.&quot;, &quot;author-link&quot;=&gt;&quot;/about/#sam&quot;, &quot;articles-link&quot;=&gt;&quot;/articles-by-author/sam/&quot;}</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 March 30, 2024]]></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) -->
 
@@ -2587,7 +2620,7 @@ Using the term desistence in this way does not imply anything about the identity
       <td>Published article</td>
     </tr>
     <tr>
-      <td>Various [<a href="https://web.archive.org/web/20201116155321/https://www.gpref.bedfordshire.nhs.uk/media/160288/Treatment%20of%20Gender_Dysphoria_in_Transwomen_(Male_to_Female_Transsexuals).pdf">PDF</a>] [<a href="https://medicines.blmkccg.nhs.uk/wp-content/uploads/2020/05/Treatment-of-Gender-Dysphoria-in-Transwomen-Male-to-Female-Transsexuals-Pt-Information-Leaflet-published-by-West-London-Mental-health-NHS-Trust-Information.pdf">PDF</a>] [<a href="https://web.archive.org/web/20210920002540/http://medicinesmanagement.doncasterccg.nhs.uk/wp-content/uploads/2018/06/Doncaster-and-Bassetlaw-Transgender-women-prescribing-guidance.pdf">PDF</a>] [<a href="http://www.sunderlandccg.nhs.uk/wp-content/uploads/2016/08/SCCG-Gender-Dysphoria-Feminising-Hormones-Dec-2015-DecX2016.pdf">PDF</a>] [<a href="https://web.archive.org/web/20210419204521/https://remedy.bnssgccg.nhs.uk/media/3218/the-laurels-transgender-prescribing-guideline.pdf">PDF</a>] [<a href="https://awttc.nhs.wales/files/guidelines-and-pils/endocrine-management-of-gender-dysphoria-in-adults-pdf/">PDF</a>]</td>
+      <td>Various [<a href="https://web.archive.org/web/20201116155321/https://www.gpref.bedfordshire.nhs.uk/media/160288/Treatment%20of%20Gender_Dysphoria_in_Transwomen_(Male_to_Female_Transsexuals).pdf">PDF</a>] [<a href="https://web.archive.org/web/20230410072004/https://medicines.blmkccg.nhs.uk/wp-content/uploads/2020/05/Treatment-of-Gender-Dysphoria-in-Transwomen-Male-to-Female-Transsexuals-Pt-Information-Leaflet-published-by-West-London-Mental-health-NHS-Trust-Information.pdf">PDF</a>] [<a href="https://web.archive.org/web/20210920002540/http://medicinesmanagement.doncasterccg.nhs.uk/wp-content/uploads/2018/06/Doncaster-and-Bassetlaw-Transgender-women-prescribing-guidance.pdf">PDF</a>] [<a href="https://web.archive.org/web/20230606024510/https://www.sunderlandccg.nhs.uk/wp-content/uploads/2016/08/SCCG-Gender-Dysphoria-Feminising-Hormones-Dec-2015-DecX2016.pdf">PDF</a>] [<a href="https://web.archive.org/web/20210419204521/https://remedy.bnssgccg.nhs.uk/media/3218/the-laurels-transgender-prescribing-guideline.pdf">PDF</a>] [<a href="https://awttc.nhs.wales/files/guidelines-and-pils/endocrine-management-of-gender-dysphoria-in-adults-pdf/">PDF</a>]</td>
       <td>Various / National Health Service (NHS) Trusts</td>
       <td>Various</td>
       <td>Online documents</td>
@@ -2716,7 +2749,7 @@ Using the term desistence in this way does not imply anything about the identity
   </thead>
   <tbody>
     <tr>
-      <td><a href="https://www.undp.org/asia-pacific/publications/blueprint-provision-comprehensive-care-trans-people-and-trans-communities-asia-and-pacific">Blueprint for the Provision of Comprehensive Care for Trans People and Trans Communities in Asia and the Pacific</a> [<a href="https://www.undp.org/sites/g/files/zskgke326/files/migration/asia_pacific_rbap/rbap-hhd-2015-asia-pacific-trans-health-blueprint.pdf">PDF</a>]</td>
+      <td><a href="https://www.undp.org/asia-pacific/publications/blueprint-provision-comprehensive-care-trans-people-and-trans-communities-asia-and-pacific">Blueprint for the Provision of Comprehensive Care for Trans People and Trans Communities in Asia and the Pacific</a> [<a href="https://web.archive.org/web/20240403010222/https://www.undp.org/sites/g/files/zskgke326/files/migration/asia_pacific_rbap/rbap-hhd-2015-asia-pacific-trans-health-blueprint.pdf">PDF</a>]</td>
       <td>Health Policy Project / Asia Pacific Transgender Network / United Nations Development Programme [Asia and the Pacific]</td>
       <td>2015</td>
       <td>Online document</td>
@@ -2728,7 +2761,7 @@ Using the term desistence in this way does not imply anything about the identity
       <td>Online document</td>
     </tr>
     <tr>
-      <td><a href="http://www.sapphokolkata.in/wp-content/uploads/2019/09/GAT-Revised-Updated_19.09.19.pdf">A Good Practice Guide to Gender-Affirmative Care</a></td>
+      <td><a href="https://web.archive.org/web/20220916065347/http://www.sapphokolkata.in/wp-content/uploads/2019/09/GAT-Revised-Updated_19.09.19.pdf">A Good Practice Guide to Gender-Affirmative Care</a></td>
       <td>Sappho for Equality [India]</td>
       <td>2019</td>
       <td>Online document</td>
@@ -2769,7 +2802,7 @@ Using the term desistence in this way does not imply anything about the identity
   <li>Fisher, A. D., Senofonte, G., Cocchetti, C., Guercio, G., Lingiardi, V., Meriggiola, M. C., Mosconi, M., Motta, G., Ristori, J., Speranza, A. M., Pierdominici, M., Maggi, M., Corona, G., &amp; Lombardo, F. (2021). SIGIS–SIAMS–SIE position statement of gender affirming hormonal treatment in transgender and non-binary people. <em>Journal of Endocrinological Investigation</em>, <em>45</em>(3), 657–673. [DOI:<a href="https://doi.org/10.1007/s40618-021-01694-2">10.1007/s40618-021-01694-2</a>]</li>
   <li>Godano, A., Maggi, M., Jannini, E., Meriggiola, M. C., Ghigo, E., Todarello, O., Lenzi, A., &amp; Manieri, C. (2009). SIAMS-ONIG Consensus on Hormonal Treatment in Gender Identity Disorders. <em>Journal of Endocrinological Investigation</em>, <em>32</em>(10), 857–864. [DOI:<a href="https://doi.org/10.1007/BF03345758">10.1007/BF03345758</a>]</li>
   <li>Gorton, N., Jaffe, J. M., Thompson, J., Menkin, D., Nesteby, A., Dunn, D., Baker, K. K., Harbatkin, D., Do, T., Radix, A., Meacher, P., Goldstein, Z., Carpenter, W., Caine, M., Henn, S., Murayama, R., Feldmann, J., &amp; Zayas, S. (2019). <em>TransLine Gender Affirming Hormone Therapy Prescriber Guidelines.</em> San Francisco: Lyon-Martin Health Services/TransLine. [<a href="https://transline.zendesk.com/hc/en-us/articles/229373288-TransLine-Hormone-Therapy-Prescriber-Guidelines">URL</a>] [<a href="https://transline.zendesk.com/hc/en-us/article_attachments/360047702053/TransLine_HRT_Guidelines_FINAL.pdf">PDF</a>]</li>
-  <li>Health Policy Project, Asia Pacific Transgender Network, United Nations Development Programme. (2015). <em>Blueprint for the Provision of Comprehensive Care for Trans People and Trans Communities.</em> Washington, DC: Futures Group, Health Policy Project. [<a href="https://www.asia-pacific.undp.org/content/dam/rbap/docs/Research%20&amp;%20Publications/hiv_aids/rbap-hhd-2015-asia-pacific-trans-health-blueprint.pdf">PDF</a>]</li>
+  <li>Health Policy Project, Asia Pacific Transgender Network, United Nations Development Programme. (2015). <em>Blueprint for the Provision of Comprehensive Care for Trans People and Trans Communities.</em> Washington, DC: Futures Group, Health Policy Project. [<a href="https://www.undp.org/asia-pacific/publications/blueprint-provision-comprehensive-care-trans-people-and-trans-communities-asia-and-pacific">URL</a>] [<a href="https://web.archive.org/web/20240403010222/https://www.undp.org/sites/g/files/zskgke326/files/migration/asia_pacific_rbap/rbap-hhd-2015-asia-pacific-trans-health-blueprint.pdf">PDF</a>]</li>
   <li>Hembree, W. C., Cohen-Kettenis, P., Delemarre-Van De Waal, H. A., Gooren, L. J., Meyer III, W. J., Spack, N. P., Tangpricha, V., &amp; Montori, V. M. (2009). Endocrine treatment of transsexual persons: an Endocrine Society clinical practice guideline. <em>The Journal of Clinical Endocrinology &amp; Metabolism</em>, <em>94</em>(9), 3132–3154. [DOI:<a href="https://doi.org/10.1210/jc.2009-0345">10.1210/jc.2009-0345</a>]</li>
   <li>Hembree, W. C., Cohen-Kettenis, P. T., Gooren, L., Hannema, S. E., Meyer, W. J., Murad, M. H., Rosenthal, S. M., Safer, J. D., Tangpricha, V., &amp; T’Sjoen, G. G. (2017). Endocrine Treatment of Gender-Dysphoric/Gender-Incongruent Persons: An Endocrine Society Clinical Practice Guideline. <em>The Journal of Clinical Endocrinology and Metabolism</em>, <em>102</em>(11), 3869–3903. [DOI:<a href="https://doi.org/10.1210/jc.2017-01658">10.1210/jc.2017-01658</a>] [<a href="https://academic.oup.com/jcem/article-pdf/102/11/3869/21533864/jc.2017-01658.pdf">PDF</a>]</li>
   <li>International Planned Parenthood Federation (IPPF). (2015). <em>IMAP Statement on Hormone Therapy for Transgender People.</em> International Medical Advisory Panel/International Planned Parenthood Federation. [<a href="https://www.ippf.org/resource/imap-statement-hormone-therapy-transgender-people">URL</a>] [<a href="https://www.ippf.org/sites/default/files/ippf_imap_transgender.pdf">PDF</a>]</li>
@@ -2779,13 +2812,13 @@ Using the term desistence in this way does not imply anything about the identity
   <li>Pan American Health Organization, John Snow, Inc., World Professional Association for Transgender Health, et al. (2014). <em>Blueprint for the Provision of Comprehensive Care for Trans Persons and</em> <em>Their Communities in the Caribbean and Other Anglophone Countries.</em> Arlington: John Snow, Inc. [<a href="https://iris.paho.org/handle/10665.2/31360">Alt</a>] [<a href="https://web.archive.org/web/20210419205021/https://www.paho.org/hq/dmdocuments/2014/2014-cha-blueprint-comprehensive-anglo-countries.pdf">PDF</a>]</li>
   <li>Radix, A. (2019). Hormone Therapy for Transgender Adults. <em>The Urologic Clinics of North America</em>, <em>46</em>(4), 467–473. [DOI:<a href="https://doi.org/10.1016/j.ucl.2019.07.001">10.1016/j.ucl.2019.07.001</a>]</li>
   <li>Radix, A. (2019). Primary Care of Transgender Adults. In Poretsky, L., &amp; Hembree, W. C. (Eds.). <em>Transgender Medicine: A Multidisciplinary Approach</em> <em>(Contemporary Endocrinology)</em> (pp. 51–67). Cham: Humana Press. [DOI:<a href="https://doi.org/10.1007/978-3-030-05683-4_4">10.1007/978-3-030-05683-4_4</a>]</li>
-  <li>Sappho for Equality. (2019). <em>A Good Practice Guide to Gender-Affirmative Care.</em> Kolkata: Sappho for Equality. [<a href="http://www.sapphokolkata.in/wp-content/uploads/2019/09/GAT-Revised-Updated_19.09.19.pdf">PDF</a>]</li>
-  <li>Seal, L. J. (2016). <em>Information About Hormonal Treatment for Trans Women.</em> London: West London Mental Health NHS Trust/West London NHS Trust. [<a href="https://medicines.blmkccg.nhs.uk/wp-content/uploads/2020/05/Treatment-of-Gender-Dysphoria-in-Transwomen-Male-to-Female-Transsexuals-Pt-Information-Leaflet-published-by-West-London-Mental-health-NHS-Trust-Information.pdf">PDF</a>]</li>
+  <li>Sappho for Equality. (2019). <em>A Good Practice Guide to Gender-Affirmative Care.</em> Kolkata: Sappho for Equality. [<a href="https://web.archive.org/web/20220916065347/http://www.sapphokolkata.in/wp-content/uploads/2019/09/GAT-Revised-Updated_19.09.19.pdf">PDF</a>]</li>
+  <li>Seal, L. J. (2016). <em>Information About Hormonal Treatment for Trans Women.</em> London: West London Mental Health NHS Trust/West London NHS Trust. [<a href="https://web.archive.org/web/20230410072004/https://medicines.blmkccg.nhs.uk/wp-content/uploads/2020/05/Treatment-of-Gender-Dysphoria-in-Transwomen-Male-to-Female-Transsexuals-Pt-Information-Leaflet-published-by-West-London-Mental-health-NHS-Trust-Information.pdf">PDF</a>]</li>
   <li>Seal, L., &amp; Barrett, J. (2017). <em>Shared Care Prescribing Guidance for Treatment of Gender Dysphoria in Transwomen (Male to Female Transsexuals).</em> London: West London Mental Health NHS Trust/West London NHS Trust. [<a href="https://web.archive.org/web/20201116155321/https://www.gpref.bedfordshire.nhs.uk/media/160288/Treatment%20of%20Gender_Dysphoria_in_Transwomen_(Male_to_Female_Transsexuals).pdf">PDF</a>]</li>
   <li>Sullivan, C., &amp; Dean, J. (2015). <em>Prescribing Guideline. Pharmacological Treatment of Gender Dysphoria.</em> Devon: Devon Partnership NHS Trust. [<a href="https://web.archive.org/web/20210419204521/https://remedy.bnssgccg.nhs.uk/media/3218/the-laurels-transgender-prescribing-guideline.pdf">PDF</a>]</li>
   <li>Tangpricha, V., &amp; Safer, J. D. (2020). <em>Transgender Women: Evaluation and Management.</em> UpToDate. [<a href="https://www.uptodate.com/contents/transgender-women-evaluation-and-management">URL</a>] [<a href="https://files.transfemscience.org/pdfs/Tangpricha%20&amp;%20Safer%20(2019)%20-%20Transgender%20Women_%20Evaluation%20and%20Management%20-%20UpToDate.pdf">PDF</a>]</li>
   <li>Telfer, M. M., Tollit, M. A., Pace, C. C., &amp; Pang, K. C. (2020). <em>Australian Standards of Care and Treatment Guidelines for Trans and Gender Diverse Children and Adolescents Version 1.2</em>. Melbourne: The Royal Children’s Hospital. [<a href="https://www.rch.org.au/uploadedFiles/Main/Content/adolescent-medicine/australian-standards-of-care-and-treatment-guidelines-for-trans-and-gender-diverse-children-and-adolescents.pdf">PDF</a>]</li>
-  <li>Thomas, C. (2015). <em>Guidelines for the Use of Feminising Hormone Therapy. Information for Primary Care.</em> Sunderland: City Hospitals Sunderland NHS Trust. [<a href="https://www.sunderlandccg.nhs.uk/wp-content/uploads/2016/08/SCCG-Gender-Dysphoria-Feminising-Hormones-Dec-2015-DecX2016.pdf">PDF</a>]</li>
+  <li>Thomas, C. (2015). <em>Guidelines for the Use of Feminising Hormone Therapy. Information for Primary Care.</em> Sunderland: City Hospitals Sunderland NHS Trust. [<a href="https://web.archive.org/web/20230606024510/https://www.sunderlandccg.nhs.uk/wp-content/uploads/2016/08/SCCG-Gender-Dysphoria-Feminising-Hormones-Dec-2015-DecX2016.pdf">PDF</a>]</li>
   <li>Thompson, J., Hopwood, R. A., deNormand, S., &amp; 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>
   <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., &amp; 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>
   <li>Trans Care BC. (2021). <em>Gender-affirming Care for Trans, Two-Spirit, and Gender Diverse Patients in BC: A Primary Care Toolkit.</em> Vancouver: Provincial Health Services Authority/Trans Care BC. [<a href="http://www.phsa.ca/transcarebc/health-professionals/clinical-resources">URL</a>] [<a href="http://www.phsa.ca/transcarebc/Documents/HealthProf/Primary-Care-Toolkit.pdf">PDF</a>]</li>
@@ -3730,7 +3763,7 @@ Using the term desistence in this way does not imply anything about the identity
   <li>Patel, K. T., Adeel, S., Rodrigues Miragaya, J., &amp; Tangpricha, V. (2022). Progestogen Use in Gender-Affirming Hormone Therapy: A Systematic Review. <em>Endocrine Practice</em>, <em>28</em>(12), 1244–1252. [DOI:<a href="https://doi.org/10.1016/j.eprac.2022.08.012">10.1016/j.eprac.2022.08.012</a>]</li>
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   <li>Pfeifer, S., Butts, S., Dumesic, D., Fossum, G., Gracia, C., La Barbera, A., Mersereau, J., Odem, R., Penzias, A., Pisarska, M., Rebar, R., Reindollar, R., Rosen, M., Sandlow, J., Sokol, R., Vernon, M., &amp; Widra, E. (2017). Combined hormonal contraception and the risk of venous thromboembolism: a guideline. <em>Fertility and Sterility</em>, <em>107</em>(1), 43–51. [DOI:<a href="https://doi.org/10.1016/j.fertnstert.2016.09.027">10.1016/j.fertnstert.2016.09.027</a>]</li>
-  <li>Phillips, I., Shah, S. I., Duong, T., Abel, P., &amp; Langley, R. E. (2014). Androgen Deprivation Therapy and the Re-emergence of Parenteral Estrogen in Prostate Cancer. <em>Oncology &amp; Hematology Review</em>, <em>10</em>(1), 42–47. [<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4052190/">PubMed Central</a>] [DOI:<a href="https://doi.org/10.17925/ohr.2014.10.1.42">10.17925/ohr.2014.10.1.42</a>] [<a href="https://touchoncology.com/genitourinary-cancers/journal-articles/androgen-deprivation-therapy-and-the-re-emergence-of-parenteral-estrogen-in-prostate-cancer/">URL</a>]</li>
+  <li>Phillips, I., Shah, S. I., Duong, T., Abel, P., &amp; Langley, R. E. (2014). Androgen Deprivation Therapy and the Re-emergence of Parenteral Estrogen in Prostate Cancer. <em>Oncology &amp; Hematology Review</em>, <em>10</em>(1), 42–47. [<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4052190/">PubMed Central</a>] [DOI:<a href="https://touchoncology.com/genitourinary-cancers/journal-articles/androgen-deprivation-therapy-and-the-re-emergence-of-parenteral-estrogen-in-prostate-cancer/">10.17925/ohr.2014.10.1.42</a>]</li>
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   <li>Pomp, E. R., Rosendaal, F. R., &amp; Doggen, C. J. (2008). Smoking increases the risk of venous thrombosis and acts synergistically with oral contraceptive use. <em>American Journal of Hematology</em>, <em>83</em>(2), 97–102. [DOI:<a href="https://doi.org/10.1002/ajh.21059">10.1002/ajh.21059</a>]</li>
   <li>Pond, S. M., &amp; Tozer, T. N. (1984). First-Pass Elimination. <em>Clinical Pharmacokinetics</em>, <em>9</em>(1), 1–25. [DOI:<a href="https://doi.org/10.2165/00003088-198409010-00001">10.2165/00003088-198409010-00001</a>]</li>
@@ -4488,13 +4521,13 @@ 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., &amp; 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., &amp; 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., &amp; Kaufman, J. M. (1999). A critical evaluation of simple methods for the estimation of free testosterone in serum. <em>The Journal of Clinical Endocrinology &amp; 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>{&quot;first_name&quot;=&gt;&quot;Aly&quot;, &quot;last_name&quot;=&gt;&quot;W.&quot;, &quot;author-link&quot;=&gt;&quot;/about/#aly&quot;, &quot;articles-link&quot;=&gt;&quot;/articles-by-author/aly/&quot;}</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>2024-03-23T00:00:00-07:00</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>{&quot;first_name&quot;=&gt;&quot;Aly&quot;, &quot;last_name&quot;=&gt;&quot;W.&quot;, &quot;author-link&quot;=&gt;&quot;/about/#aly&quot;, &quot;articles-link&quot;=&gt;&quot;/articles-by-author/aly/&quot;}</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>2024-04-02T00:00:00-07:00</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>
 
 <!-- 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 July 1, 2020
-   | Last modified March 23, 2024</p>
+   | Last modified April 2, 2024</p>
 
 <h2 id="abstract--tldr">Abstract / TL;DR</h2>
 
@@ -4506,7 +4539,7 @@ Using the term desistence in this way does not imply anything about the identity
 
 <p>Before 2015, there were only a few mentions in the literature of bicalutamide for transfeminine people and a handful of anecdotal reports online of transfeminine people using it. The earliest clear mention of bicalutamide in the literature in the context of transfeminine hormone therapy was by <a href="https://en.wikipedia.org/wiki/Louis_Gooren">Louis Gooren</a> in 2011 (<a href="http://doi.org/10.1056/NEJMcp1008161">Gooren, 2011</a>). Gooren is a major longtime researcher in the field of transgender medicine and is one of the coauthors of the <a href="https://en.wikipedia.org/wiki/Endocrine_Society">Endocrine Society</a>’s transgender hormone therapy guidelines (<a href="https://doi.org/10.1210/jc.2009-0345">Hembree et al., 2009</a>; <a href="https://doi.org/10.1210/jc.2017-01658">Hembree et al., 2017</a>). He and his colleagues at the <a href="https://en.wikipedia.org/wiki/Center_of_Expertise_on_Gender_Dysphoria">Center of Expertise on Gender Dysphoria</a> of the <a href="https://en.wikipedia.org/wiki/VU_University_Medical_Center">Vrije Universiteit Medical Center</a> (VUMC) in Amsterdam, Netherlands had conducted studies on <a href="https://en.wikipedia.org/wiki/Nilutamide">nilutamide</a> (Anandron, Nilandron) as an antiandrogen for transfeminine people in the late 1980s and early 1990s (<a href="https://kinseyinstitute.org/pdf/HBIGDA_S10_1987OCR.pdf#page=55">de Voogt et al., 1987a</a>; <a href="https://doi.org/10.1002/pros.2990110403">de Voogt et al., 1987b</a>; <a href="https://doi.org/10.1210/jcem-64-4-763">Gooren et al., 1987</a>; <a href="https://kinseyinstitute.org/pdf/HBIGDA_S10_1987OCR.pdf#page=35">Johannes et al., 1987</a>; <a href="https://doi.org/10.1016/0022-4731(88)90024-6">Rao et al., 1988</a>; <a href="https://doi.org/10.1111/j.1365-2230.1989.tb02585.x">Asscheman, Gooren, &amp; Peereboom-Wynia, 1989</a>; <a href="https://doi.org/10.1007/BF01543196">van Kemenade et al., 1989</a>; <a href="https://en.wikipedia.org/wiki/Nilutamide#Transgender_hormone_therapy">Wiki</a>). However, they seem to have abandoned it—probably due to its high incidence of lung toxicity and other <a href="https://en.wikipedia.org/wiki/Off-target_activity">off-target</a> side effects. Nonetheless, Gooren began including nonsteroidal antiandrogens like flutamide and nilutamide in his publications as potential treatment options for transfeminine hormone therapy starting in the 1990s (<a href="https://doi.org/10.1300/J056v05n04_03">Asscheman &amp; Gooren, 1992</a>; <a href="http://web.archive.org/web/20070430161048/http://www.symposion.com/ijt/ijt990301.htm">Gooren, 1999</a>). Subsequently, flutamide was included in transgender health guidelines and other publications, though not necessarily favorably (e.g., <a href="https://books.google.com/books?id=IlPX6E5glDEC&amp;pg=PA66">Israel &amp; Tarver, 1997</a>; <a href="https://doi.org/10.1046/j.1365-2265.2003.01821.x">Levy, Crown, &amp; Reid, 2003</a>; <a href="https://doi.org/10.1300/J485v09n03_06">Dahl et al., 2006a</a>; <a href="https://www.cpath.ca/wp-content/uploads/2009/12/guidelines-endocrine.pdf">Dahl et al., 2006b</a>; <a href="https://doi.org/10.1210/jc.2009-0345">Hembree et al., 2009</a>; <a href="https://doi.org/10.1016/j.endoen.2012.07.004">Moreno-Pérez et al., 2012</a>). As a researcher interested in nonsteroidal antiandrogens for transfeminine people, bicalutamide—with its far better safety profile than flutamide and nilutamide—may have been appealing to Gooren. However, Gooren and his colleagues didn’t conduct clinical studies on bicalutamide for transfeminine people and never went beyond brief mention of it for such uses in their publications. Nor did any other academics.</p>
 
-<p>Besides transfeminine people and men with prostate cancer, bicalutamide has been studied for use in the treatment of androgen-dependent conditions in other populations. For example, it has been used in the treatment of <a href="https://en.wikipedia.org/wiki/Hirsutism">hirsutism</a> (excessive facial/body hair growth) in cisgender women with and without <a href="https://en.wikipedia.org/wiki/Polycystic_ovary_syndrome">polycystic ovary syndrome</a> (PCOS) (<a href="https://doi.org/10.1093/humrep/14.Suppl_3.366-a">Müderris, Bayram, &amp; Güven, 1999</a>; <a href="https://doi.org/10.1080/gye.16.1.63.66">Müderris et al., 2002</a>; <a href="https://doi.org/10.1159/000081973">Bahceci et al., 2004</a>; <a href="https://www.turkiyeklinikleri.com/article/en-hirsutizm-tedavisinde-flutamid-ve-bikalutamid-kullanimi-55753.html">Müderris &amp; Öner, 2009</a>; <a href="https://endo.confex.com/endo/2016endo/webprogram/Paper26631.html">Moretti et al., 2016</a>; <a href="https://doi.org/10.1210/jc.2017-01186">Moretti et al., 2018</a>; <a href="https://en.wikipedia.org/wiki/Medical_uses_of_bicalutamide#Medical_uses_of_bicalutamide#Skin_and_hair_conditions">Wiki</a>). Bicalutamide has also been studied in combination with <a href="https://en.wikipedia.org/wiki/Anastrozole">anastrozole</a> (Arimidex), an <a href="https://en.wikipedia.org/wiki/Aromatase_inhibitor">aromatase inhibitor</a>, for the treatment of <a href="https://en.wikipedia.org/wiki/Familial_male-limited_precocious_puberty">gonadotropin-independent precocious puberty</a> in cisgender boys (<a href="https://doi.org/10.1016/j.jpeds.2006.04.027">Kreher et al., 2006</a>; <a href="https://doi.org/10.1159/000239668">Lewis et al., 2009</a>; <a href="https://doi.org/10.1515/JPEM.2009.22.12.1163">Mitre &amp; Lteif, 2009</a>; <a href="https://doi.org/10.1159/000239668">Stenger et al., 2009</a>; <a href="https://doi.org/10.1542/peds.2010-0596">Lenz et al., 2010</a>; <a href="https://doi.org/10.1515/jpem.2010.161">Reiter et al., 2010</a>; <a href="https://doi.org/10.1507/endocrj.ej11-0214">Tessaris et al., 2012</a>; <a href="https://doi.org/10.4274/jcrpe.2067">Özcabı et al., 2015</a>; <a href="https://doi.org/10.1007/s42000-018-0029-1">Kor, 2018</a>; <a href="https://doi.org/10.1515/jpem-2018-0419">Arya &amp; Davies, 2019</a>; <a href="https://doi.org/10.4158/ACCR-2018-0246">Nabhan &amp; Eugster, 2019</a>; <a href="https://doi.org/10.1097/DBP.0000000000000865">Finkle et al., 2020</a>; <a href="https://doi.org/10.4274/jcrpe.galenos.2020.2020.0067">Gurnurkar, DiLillo, &amp; Carakushansky, 2021</a>; <a href="https://en.wikipedia.org/wiki/Medical_uses_of_bicalutamide#Male_early_puberty">Wiki</a>). This is a rare form of <a href="https://en.wikipedia.org/wiki/Precocious_puberty">precocious puberty</a> in which <a href="https://en.wikipedia.org/wiki/Gonadotropin-releasing_hormone_modulator">gonadotropin-releasing hormone modulators</a> are not effective. A <a href="https://en.wikipedia.org/wiki/Phases_of_clinical_research#Phase_II">phase 2</a> clinical trial was completed and a <a href="https://en.wikipedia.org/wiki/New_Drug_Application">New Drug Application</a> (NDA) was submitted in the United States for treatment of the condition with bicalutamide and anastrozole, but the application was not approved due to inadequate evidence of effectiveness on the primary efficacy endpoint of limiting height (<a href="https://web.archive.org/web/20190730023433/https://www.fda.gov/media/75809/download">AstraZeneca, 2008</a>). However, bicalutamide is still used <a href="https://en.wikipedia.org/wiki/Off-label_use">off-label</a> for this indication, and information on bicalutamide for this use is provided in the the Casodex <a href="https://en.wikipedia.org/wiki/Food_and_Drug_Administration">Food and Drug Administration</a> (FDA) label (<a href="https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/020498s028lbl.pdf">FDA, 2017</a>).</p>
+<p>Besides transfeminine people and men with prostate cancer, bicalutamide has been studied for use in the treatment of androgen-dependent conditions in other populations. For example, it has been used in the treatment of <a href="https://en.wikipedia.org/wiki/Hirsutism">hirsutism</a> (excessive facial/body hair growth) in cisgender women with and without <a href="https://en.wikipedia.org/wiki/Polycystic_ovary_syndrome">polycystic ovary syndrome</a> (PCOS) (<a href="https://doi.org/10.1093/humrep/14.Suppl_3.366-a">Müderris, Bayram, &amp; Güven, 1999</a>; <a href="https://doi.org/10.1080/gye.16.1.63.66">Müderris et al., 2002</a>; <a href="https://doi.org/10.1159/000081973">Bahceci et al., 2004</a>; <a href="https://www.turkiyeklinikleri.com/article/en-hirsutizm-tedavisinde-flutamid-ve-bikalutamid-kullanimi-55753.html">Müderris &amp; Öner, 2009</a>; <a href="https://web.archive.org/web/20221108144934/https://endo.confex.com/endo/2016endo/webprogram/Paper26631.html">Moretti et al., 2016</a>; <a href="https://doi.org/10.1210/jc.2017-01186">Moretti et al., 2018</a>; <a href="https://en.wikipedia.org/wiki/Medical_uses_of_bicalutamide#Medical_uses_of_bicalutamide#Skin_and_hair_conditions">Wiki</a>). Bicalutamide has also been studied in combination with <a href="https://en.wikipedia.org/wiki/Anastrozole">anastrozole</a> (Arimidex), an <a href="https://en.wikipedia.org/wiki/Aromatase_inhibitor">aromatase inhibitor</a>, for the treatment of <a href="https://en.wikipedia.org/wiki/Familial_male-limited_precocious_puberty">gonadotropin-independent precocious puberty</a> in cisgender boys (<a href="https://doi.org/10.1016/j.jpeds.2006.04.027">Kreher et al., 2006</a>; <a href="https://doi.org/10.1159/000239668">Lewis et al., 2009</a>; <a href="https://doi.org/10.1515/JPEM.2009.22.12.1163">Mitre &amp; Lteif, 2009</a>; <a href="https://doi.org/10.1159/000239668">Stenger et al., 2009</a>; <a href="https://doi.org/10.1542/peds.2010-0596">Lenz et al., 2010</a>; <a href="https://doi.org/10.1515/jpem.2010.161">Reiter et al., 2010</a>; <a href="https://doi.org/10.1507/endocrj.ej11-0214">Tessaris et al., 2012</a>; <a href="https://doi.org/10.4274/jcrpe.2067">Özcabı et al., 2015</a>; <a href="https://doi.org/10.1007/s42000-018-0029-1">Kor, 2018</a>; <a href="https://doi.org/10.1515/jpem-2018-0419">Arya &amp; Davies, 2019</a>; <a href="https://doi.org/10.4158/ACCR-2018-0246">Nabhan &amp; Eugster, 2019</a>; <a href="https://doi.org/10.1097/DBP.0000000000000865">Finkle et al., 2020</a>; <a href="https://doi.org/10.4274/jcrpe.galenos.2020.2020.0067">Gurnurkar, DiLillo, &amp; Carakushansky, 2021</a>; <a href="https://en.wikipedia.org/wiki/Medical_uses_of_bicalutamide#Male_early_puberty">Wiki</a>). This is a rare form of <a href="https://en.wikipedia.org/wiki/Precocious_puberty">precocious puberty</a> in which <a href="https://en.wikipedia.org/wiki/Gonadotropin-releasing_hormone_modulator">gonadotropin-releasing hormone modulators</a> are not effective. A <a href="https://en.wikipedia.org/wiki/Phases_of_clinical_research#Phase_II">phase 2</a> clinical trial was completed and a <a href="https://en.wikipedia.org/wiki/New_Drug_Application">New Drug Application</a> (NDA) was submitted in the United States for treatment of the condition with bicalutamide and anastrozole, but the application was not approved due to inadequate evidence of effectiveness on the primary efficacy endpoint of limiting height (<a href="https://web.archive.org/web/20190730023433/https://www.fda.gov/media/75809/download">AstraZeneca, 2008</a>). However, bicalutamide is still used <a href="https://en.wikipedia.org/wiki/Off-label_use">off-label</a> for this indication, and information on bicalutamide for this use is provided in the the Casodex <a href="https://en.wikipedia.org/wiki/Food_and_Drug_Administration">Food and Drug Administration</a> (FDA) label (<a href="https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/020498s028lbl.pdf">FDA, 2017</a>).</p>
 
 <p>Although there was little discussion or use of bicalutamide in transfeminine people prior to 2015, this started to change in mid-2015. At that time, the <a href="https://en.wikipedia.org/wiki/Bicalutamide">Wikipedia content for bicalutamide</a> was greatly expanded, which made information about bicalutamide more accessible. In addition, certain transfeminine people, noting its advantages over existing options and its excellent potential for use in transfeminine hormone therapy, began advocating for use of bicalutamide in transfeminine people in online circles. A number of open-minded clinicians started adopting bicalutamide in transfeminine people around this time and thereafter as well. The first clinical study of bicalutamide in transfeminine people, which began in 2013, was published as an abstract in 2017 and as a full paper in 2019 (<a href="https://files.transfemscience.org/pdfs/Neyman,%20Fuqua,%20&amp;%20Eugster%20(2017)%20-%20Bicalutamide%20as%20an%20Androgen%20Blocker%20with%20Secondary%20Effect%20of%20Promoting%20Feminization%20in%20Male%20to%20Female%20(MTF)%20Transgender%20Adolescents.pdf#page=4">Neyman, Fuqua, &amp; Eugster, 2017</a>; <a href="https://doi.org/10.1016/j.jadohealth.2018.10.296">Neyman, Fuqua, &amp; Eugster, 2019</a>). It was a small retrospective chart review of bicalutamide alone as a second-line <a href="https://en.wikipedia.org/wiki/Puberty_blocker">puberty blocker</a> in adolescent transgender girls for whom <a href="https://en.wikipedia.org/wiki/Gonadotropin-releasing_hormone_analogue">gonadotropin-releasing hormone analogues</a> were denied by insurance. As of present, it remains the only published clinical data on bicalutamide in transfeminine people. It’s not exactly great data by any means, but it’s a study at least. The researchers who conducted the study had previously published on bicalutamide as a puberty blocker in boys with gonadotropin-independent precocious puberty (e.g., <a href="https://doi.org/10.1542/peds.2010-0596">Lenz et al., 2010</a>; <a href="https://doi.org/10.1007/978-1-4419-1795-9_71">Haddad &amp; Eugster, 2012</a>). While limited in its findings, <a href="https://doi.org/10.1016/j.jadohealth.2018.10.296">Neyman, Fuqua, and Eugster (2019)</a> helped to generate significant interest among clinicians and researchers in bicalutamide for use in transfeminine hormone therapy.</p>
 
@@ -4516,7 +4549,7 @@ Using the term desistence in this way does not imply anything about the identity
 
 <p>The transgender medical community has been reluctant to endorse the use of bicalutamide in transfeminine people to date. This is because of the lack of clinical studies and characterization of bicalutamide in transfeminine people, most importantly in terms of safety. There have been concerns about rare instances of <a href="https://en.wikipedia.org/wiki/Liver_failure">liver failure</a> that have occurred with bicalutamide in men with prostate cancer (<a href="https://en.wikipedia.org/wiki/Side_effects_of_bicalutamide#Liver_toxicity">Wiki</a>). The reported cases of liver toxicity with bicalutamide have generally been sudden-onset and severe. Rare liver toxicity is an acceptable risk in men with prostate cancer because the <a href="https://en.wikipedia.org/wiki/Risk%E2%80%93benefit_ratio">risk–benefit ratio</a> of bicalutamide therapy is very favorable, with the benefit of treating prostate cancer vastly outweighing the harm of the very rare instances of liver problems. But transfeminine people are typically young and healthy, and bicalutamide isn’t treating a terminal illness when it’s used in us. If a transfeminine person develops liver failure and dies because of bicalutamide, that’s unnecessary harm and a life needlessly lost. Accordingly, the <a href="https://en.wikipedia.org/wiki/University_of_California,_San_Francisco">University of California San Francisco</a> (UCSF) transgender care guidelines warn against use of bicalutamide in transfeminine people currently due to potential liver risks (<a href="https://transcare.ucsf.edu/guidelines">Deutsch, 2016</a>). Aside from risks, there is also a lack of data to guide appropriate dosing of bicalutamide in transfeminine people at this time. A typical bicalutamide dosage of 50 mg/day is being used and recommended, but this has been arbitrarily chosen with little basis to support it.</p>
 
-<p>To date, there are 10 published case reports of serious <a href="https://en.wikipedia.org/wiki/Hepatotoxicity">liver toxicity</a> in association with bicalutamide (<a href="https://en.wikipedia.org/wiki/Template:Published_case_reports_of_bicalutamide-associated_liver_injury">Table</a>). All of these cases were in men with prostate cancer and all occurred within 6 months of initiation of bicalutamide therapy, with two of the cases resulting in death. While this is not a lot of cases and may seem reassuring, it must be noted that quantity of published case reports tends to vastly underestimate the true incidence of rare adverse reactions. As an example, there are around 50 published case reports of meningioma with cyproterone acetate (<a href="https://en.wikipedia.org/wiki/Template:Published_case_reports_of_cyproterone_acetate-associated_meningioma">Table</a>), but a recent large study by the French government found that there were more than 500 <em>operated</em> instances of meningioma in association with high-dose cyproterone acetate over an 8-year period in France alone (<a href="/articles/cpa-meningioma/">Aly, 2020</a>). Accordingly, as of writing there are 40 reports of liver failure, including 25 consequent deaths, in association with bicalutamide in the U.S. FDA’s international <a href="https://www.fda.gov/drugs/questions-and-answers-fdas-adverse-event-reporting-system-faers/fda-adverse-event-reporting-system-faers-public-dashboard">MedWatch/FAERS database</a>. (As well as 240 cases of <a href="https://en.wikipedia.org/wiki/Interstitial_lung_disease">interstitial lung disease</a> associated with bicalutamide notably—relative to only 14 published case reports; <a href="https://en.wikipedia.org/wiki/Template:Published_case_reports_of_bicalutamide-associated_lung_toxicity">Table</a>.) Even with this database however, fewer than 10% of serious adverse reactions are estimated to be reported (<a href="https://doi.org/10.1002/0470853093.ch17">Graham, Ahmad, &amp; Piazza-Hepp, 2002</a>). Hence, the true numbers may be much greater. These instances are merely co-occurrences, and causality in terms of bicalutamide and liver toxicity has not been established. But they are concerning nonetheless. There is additionally an unpublished case anecdote of death in a young transfeminine person associated with bicalutamide that’s been making its rounds through the transgender medical community. Per certain very credible people in the field of transgender medicine (e.g., <a href="https://callen-lorde.org/providers/asa-radix/">Asa Radix</a> and <a href="https://callen-lorde.org/providers/zil-goldstein/">Zil Goldstein</a>), she is said to have been a 20-year-old transgender girl in Texas taking bicalutamide with rapid-onset liver failure and no warning signs. This case has given clinicians and researchers who are aware of it reservations about the use of bicalutamide in hormone therapy for transfeminine people. Another case of liver failure and death in a transgender person over 60 years of age who was treated with bicalutamide has also been informally reported (<a href="https://queerdoc.com/how-do-you-know-which-t-blocker-to-take-what-is-going-on-with-bica/">QueerDoc</a>).</p>
+<p>To date, there are 10 published case reports of serious <a href="https://en.wikipedia.org/wiki/Hepatotoxicity">liver toxicity</a> in association with bicalutamide (<a href="https://en.wikipedia.org/wiki/Template:Published_case_reports_of_bicalutamide-associated_liver_injury">Table</a>). All of these cases were in men with prostate cancer and all occurred within 6 months of initiation of bicalutamide therapy, with two of the cases resulting in death. While this is not a lot of cases and may seem reassuring, it must be noted that quantity of published case reports tends to vastly underestimate the true incidence of rare adverse reactions. As an example, there are around 50 published case reports of meningioma with cyproterone acetate (<a href="https://en.wikipedia.org/wiki/Template:Published_case_reports_of_cyproterone_acetate-associated_meningioma">Table</a>), but a recent large study by the French government found that there were more than 500 <em>operated</em> instances of meningioma in association with high-dose cyproterone acetate over an 8-year period in France alone (<a href="/articles/cpa-meningioma/">Aly, 2020</a>). Accordingly, as of writing there are 40 reports of liver failure, including 25 consequent deaths, in association with bicalutamide in the U.S. FDA’s international <a href="https://www.fda.gov/drugs/questions-and-answers-fdas-adverse-event-reporting-system-faers/fda-adverse-event-reporting-system-faers-public-dashboard">MedWatch/FAERS database</a>. (As well as 240 cases of <a href="https://en.wikipedia.org/wiki/Interstitial_lung_disease">interstitial lung disease</a> associated with bicalutamide notably—relative to only 14 published case reports; <a href="https://en.wikipedia.org/wiki/Template:Published_case_reports_of_bicalutamide-associated_lung_toxicity">Table</a>.) Even with this database however, fewer than 10% of serious adverse reactions are estimated to be reported (<a href="https://doi.org/10.1002/0470853093.ch17">Graham, Ahmad, &amp; Piazza-Hepp, 2002</a>). Hence, the true numbers may be much greater. These instances are merely co-occurrences, and causality in terms of bicalutamide and liver toxicity has not been established. But they are concerning nonetheless. There is additionally an unpublished case anecdote of death in a young transfeminine person associated with bicalutamide that’s been making its rounds through the transgender medical community. Per certain very credible people in the field of transgender medicine (e.g., <a href="https://web.archive.org/web/20230321104049/https://callen-lorde.org/providers/asa-radix/">Asa Radix</a> and <a href="http://web.archive.org/web/20221208035109/https://callen-lorde.org/providers/zil-goldstein/">Zil Goldstein</a>), she is said to have been a 20-year-old transgender girl in Texas taking bicalutamide with rapid-onset liver failure and no warning signs. This case has given clinicians and researchers who are aware of it reservations about the use of bicalutamide in hormone therapy for transfeminine people. Another case of liver failure and death in a transgender person over 60 years of age who was treated with bicalutamide has also been informally reported (<a href="https://queerdoc.com/how-do-you-know-which-t-blocker-to-take-what-is-going-on-with-bica/">QueerDoc</a>).</p>
 
 <p>In any case, the reported cases of serious liver toxicity with bicalutamide in transgender people have not been published nor properly confirmed. In addition, the absolute incidence of liver toxicity with bicalutamide is likely to be very low. For instance, the incidence of abnormal <a href="https://en.wikipedia.org/wiki/Liver_function_tests">liver function tests</a> (i.e., <a href="https://en.wikipedia.org/wiki/Elevated_transaminases">elevated liver enzymes</a> on <a href="https://en.wikipedia.org/wiki/Blood_test">blood work</a>) was only 3.4% with high-dose (150 mg/day) bicalutamide monotherapy relative to 1.9% for placebo (a 1.5% difference attributable to bicalutamide) at 3.0 years of follow-up in the <a href="https://en.wikipedia.org/wiki/Early_Prostate_Cancer_(clinical_programme)">Early Prostate Cancer</a> (EPC) clinical programme, a series of three <a href="https://en.wikipedia.org/wiki/Phases_of_clinical_research#Phase_III">phase 3</a> <a href="https://en.wikipedia.org/wiki/Randomized_controlled_trial">randomized controlled trials</a> consisting of over 8,000 patients in which bicalutamide was evaluated for treatment of early prostate cancer (<a href="https://doi.org/10.1046/j.1464-410X.2003.04026.x">Anderson, 2003</a>; <a href="https://doi.org/10.1097/01.ju.0000139719.99825.54">Iversen et al., 2004</a>; <a href="https://en.wikipedia.org/wiki/Side_effects_of_bicalutamide#Liver_toxicity">Wiki</a>; <a href="https://en.wikipedia.org/wiki/Early_Prostate_Cancer_(clinical_programme)">Wiki</a>). Moreover, there were no cases of serious liver toxicity or liver failure with bicalutamide in the initial clinical development programme of bicalutamide for advanced prostate cancer, in which almost 4,000 men were treated with bicalutamide (<a href="https://doi.org/10.1159/000473847">Blackledge, 1996</a>; <a href="https://doi.org/10.1016/S0090-4295(96)80012-4">Kolvenbag &amp; Blackledge, 1996</a>; <a href="https://doi.org/10.1634/theoncologist.2-1-18">McLeod, 1997</a>; <a href="https://doi.org/10.1046/j.1464-410X.2003.04026.x">Anderson, 2003</a>; <a href="https://doi.org/10.1097/01.ju.0000139719.99825.54">Iversen et al., 2004</a>; <a href="https://en.wikipedia.org/wiki/Side_effects_of_bicalutamide#Liver_toxicity">Wiki</a>). However, it should be noted that this was with careful monitoring of liver function in patients and with prompt discontinuation of bicalutamide upon detection of clinically concerning hepatic abnormalities. About 0.5 to 1.5% of men taking 50 to 150 mg/day bicalutamide in the major clinical programmes of bicalutamide for prostate cancer developed liver changes sufficiently marked that they required discontinuation (<a href="https://doi.org/10.1159/000473847">Blackledge, 1996</a>; <a href="https://doi.org/10.1016/S0022-5347(05)64652-6">See et al., 2002</a>; <a href="https://en.wikipedia.org/wiki/Side_effects_of_bicalutamide#Liver_toxicity">Wiki</a>). Hence, regular liver monitoring is essential with bicalutamide to ensure that the possibility of severe liver toxicity is avoided.</p>
 
@@ -4574,7 +4607,7 @@ Using the term desistence in this way does not imply anything about the identity
 
 <h3 id="update-4-jamie-reed-2023-bicalutamide-liver-toxicity-case">Update 4: Jamie Reed 2023 Bicalutamide Liver Toxicity Case</h3>
 
-<p>In February 2023, Jamie Reed, a former case manager at the <a href="https://physicians.wustl.edu/specialties/lgbtq-health/washington-university-transgender-center/">The Washington University Transgender Center</a> at <a href="https://en.wikipedia.org/wiki/St._Louis_Children%27s_Hospital">St. Louis Children’s Hospital</a> in St. Louis, Missouri, published the op-ed <a href="https://www.thefp.com/p/i-thought-i-was-saving-trans-kids">“I Thought I Was Saving Trans Kids. Now I’m Blowing the Whistle.”</a> in a conservative online news outlet called <em><a href="https://en.wikipedia.org/wiki/The_Free_Press_(media_company)">The Free Press</a></em>. In this article, Reed expressed that she had become disillusioned with the medical care of transgender youth and layed out her grievances. In addition however, she briefly described an additional case of liver toxicity with bicalutamide in a transfeminine person that had allegedly occurred at her center. This individual was said to be 15 years of age and was given bicalutamide as a puberty blocker by <a href="https://profiles.wustl.edu/en/persons/christopher-lewis">Dr. Christopher Lewis</a>, one of the co-founders of the center. She was said to have subsequently developed liver toxicity and was taken off of bicalutamide. In an electronic message to the center, her mother said that they were “lucky her family was not the type to sue”. This instance, and Reed’s op-ed in general, were subsequently widely reported on in conservative news media, for instance on Fox News and in the <em>Daily Mail</em> (<a href="https://www.google.com/search?q=%22jamie+reed%22+bicalutamide+transgender+OR+trans+OR+gender-affirming&amp;tbs=cdr%3A1%2Ccd_min%3A2%2F9%2F2023%2Ccd_max%3A2%2F28%2F2023">Google</a>). In addition to her op-ed, Reed provided a sworn affidavit to the office of Republican Missouri attorney general <a href="https://en.wikipedia.org/wiki/Andrew_Bailey_(politician)">Andrew Bailey</a>, who proceeded to launch an investigation of the clinic (<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">Missouri Government, 2023a</a>). The following further information was released in the affidavit:</p>
+<p>In February 2023, Jamie Reed, a former case manager at the <a href="https://physicians.wustl.edu/specialties/lgbtq-health/washington-university-transgender-center/">The Washington University Transgender Center</a> at <a href="https://en.wikipedia.org/wiki/St._Louis_Children%27s_Hospital">St. Louis Children’s Hospital</a> in St. Louis, Missouri, published the op-ed <a href="https://www.thefp.com/p/i-thought-i-was-saving-trans-kids">“I Thought I Was Saving Trans Kids. Now I’m Blowing the Whistle.”</a> in a conservative online news outlet called <em><a href="https://en.wikipedia.org/wiki/The_Free_Press_(media_company)">The Free Press</a></em>. In this article, Reed expressed that she had become disillusioned with the medical care of transgender youth and layed out her grievances. In addition however, she briefly described an additional case of liver toxicity with bicalutamide in a transfeminine person that had allegedly occurred at her center. This individual was said to be 15 years of age and was given bicalutamide as a puberty blocker by <a href="https://profiles.wustl.edu/en/persons/christopher-lewis">Dr. Christopher Lewis</a>, one of the co-founders of the center. She was said to have subsequently developed liver toxicity and was taken off of bicalutamide. In an electronic message to the center, her mother said that they were “lucky her family was not the type to sue”. This instance, and Reed’s op-ed in general, were subsequently widely reported on in conservative news media, for instance on Fox News and in the <em>Daily Mail</em> (<a href="https://www.google.com/search?q=%22jamie+reed%22+bicalutamide+transgender+OR+trans+OR+gender-affirming&amp;tbs=cdr%3A1%2Ccd_min%3A2%2F9%2F2023%2Ccd_max%3A2%2F28%2F2023">Google</a>). In addition to her op-ed, Reed provided a sworn affidavit to the office of Republican Missouri attorney general <a href="https://en.wikipedia.org/wiki/Andrew_Bailey_(politician)">Andrew Bailey</a>, who proceeded to launch an investigation of the clinic (<a href="https://web.archive.org/web/20230828192422/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">Missouri Government, 2023a</a>). The following further information was released in the affidavit:</p>
 
 <blockquote>
   <p>One doctor at the Center, Dr. Chris Lewis, is giving patients a drug called Bicalutamide. The drug has a legitimate use for treating pancreatic cancer [<em>sic</em>], but it has a side effect of causing breasts to grow, and it can poison the liver. There are no clinical studies for using this drug for gender transitions, and there are no established standards of care for using this drug.</p>
@@ -4592,13 +4625,13 @@ Using the term desistence in this way does not imply anything about the identity
 
 <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>Following the preceding case, 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>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>), 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>
+<p>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>
@@ -4606,13 +4639,13 @@ Using the term desistence in this way does not imply anything about the identity
 
 <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>
+<p>However, 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 &gt;2x ULN after an episode of COVID and had a thorough hepatology evaluation. As ALT and AST were never &gt; 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>
+<p>Another concern with 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>
@@ -4622,33 +4655,21 @@ Using the term desistence in this way does not imply anything about the identity
   <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>
+<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>). Moreover, only the 50 mg/day dosage is used in the United States, where monotherapy is not approved. 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 Lewis and colleague’s claims, a bicalutamide dosage of 50 mg/day is not less than that generally 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>
+<h3 id="update-5-new-bicalutamide-publications-in-2022-through-2024">Update 5: New Bicalutamide Publications in 2022 Through 2024</h3>
 
 <ul>
   <li>Angus, L., Nolan, B., Zajac, J., &amp; 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., &amp; 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., &amp; 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., &amp; 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., &amp; 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&amp;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., &amp; 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., &amp; 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>Vierregger, K. S. (November 2023). Bicalutamide Use as Antiandrogen in Trans Feminine Adults - A Safety Profile. <em>USPATH Scientific Symposium, November 1-5, 2023, The Westin Westminster, Westminster, Colorado, Abstract Submissions</em>, 96–96 (abstract no. SAT-B2-T4). [<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>] [<a href="https://files.transfemscience.org/pdfs/Vierregger%20et%20al.%20(2023)%20-%20Bicalutamide%20Use%20as%20Antiandrogen%20in%20Trans%20Feminine%20Adults%20-%20A%20Safety%20Profile%20(USPATH%202023,%20abstract%20no.%20SAT-B2-T4).pdf">PDF</a>] [<a href="https://files.transfemscience.org/pdfs/wpath-symposia-materials/USPATH%202023%20Symposium%20Abstracts.pdf#page=96">Full Abstract Book</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 Scientific Symposium, November 1-5, 2023, The Westin Westminster, Westminster, Colorado, Abstract Submissions</em>, 124–124 (abstract no. SUN-B1-T5). [<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>] [<a href="https://files.transfemscience.org/pdfs/Warus%20et%20al.%20(2023)%20-%20Safety%20of%20Bicalutamide%20as%20Anti-Androgenic%20Therapy%20in%20Gender%20Affirming%20Care%20for%20Adolescents%20and%20Young%20Adults_%20A%20Retrospective%20Chart%20Review%20(USPATH%202023,%20abstract%20no.%20SUN-B1-T5).pdf">PDF</a>] [<a href="https://files.transfemscience.org/pdfs/wpath-symposia-materials/USPATH%202023%20Symposium%20Abstracts.pdf#page=124">Full Abstract Book</a>]</li>
   <li>Wilde, B., Diamond, J. B., Laborda, T. J., Frank, L., O’Gorman, M. A., &amp; 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., &amp; 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., &amp; 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., &amp; 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>
@@ -4675,7 +4696,7 @@ Using the term desistence in this way does not imply anything about the identity
   <li>Asscheman, H., &amp; 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 &amp; 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&amp;pg=PT38">Google Books</a>] [DOI:<a href="https://doi.org/10.1300/J056v05n04_03">10.1300/J056v05n04_03</a>]</li>
   <li>AstraZeneca. (2008). <em>Clinical Review. NDA. 22-310/S-001. Casodex (bicalutamide) for Testotoxicosis.</em> Food and Drug Administration/AstraZeneca Pharmaceuticals. [<a href="https://www.fda.gov/media/75809/">URL</a>] [<a href="https://www.fda.gov/media/75809/download">PDF</a>]</li>
   <li>Bahceci, M., Tuzcu, A., Canoruc, N., Tuzun, Y., Kidir, V., &amp; Aslan, C. (2004). Serum C-reactive protein (CRP) levels and insulin resistance in non-obese women with polycystic ovarian syndrome, and effect of bicalutamide on hirsutism, CRP levels and insulin resistance. <em>Hormone Research in Paediatrics</em>, <em>62</em>(6), 283–287. [DOI:<a href="https://doi.org/10.1159/000081973">10.1159/000081973</a>]</li>
-  <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>
+  <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://web.archive.org/web/20230828192422/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>
   <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., &amp; 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., &amp; 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>
@@ -4724,7 +4745,7 @@ Using the term desistence in this way does not imply anything about the identity
   <li>Mitchell, F. (2020). Guy T’Sjoen: collaborating to improve transgender wellbeing. <em>The Lancet Diabetes &amp; Endocrinology</em>, <em>8</em>(7), 568–568. [DOI:<a href="https://doi.org/10.1016/S2213-8587(20)30192-3">10.1016/S2213-8587(20)30192-3</a>]</li>
   <li>Mitre, N., &amp; Lteif, A. (2009). Treatment of familial male-limited precocious puberty (testotoxicosis) with anastrozole and bicalutamide in a boy with a novel mutation in the luteinizing hormone receptor. <em>Journal of Pediatric Endocrinology and Metabolism</em>, <em>22</em>(12), 1163–1168. [DOI:<a href="https://doi.org/10.1515/JPEM.2009.22.12.1163">10.1515/JPEM.2009.22.12.1163</a>]</li>
   <li>Moreno-Pérez, Ó., De Antonio, I. E., &amp; Grupo de Identidad y Diferenciación Sexual de la SEEN (GIDSEEN. (2012). Clinical practice guidelines for assessment and treatment of transsexualism. SEEN Identity and Sexual Differentiation Group (GIDSEEN). <em>Endocrinología y Nutrición (English Edition)</em>, <em>59</em>(6), 367–382. [DOI:<a href="https://doi.org/10.1016/j.endoen.2012.07.004">10.1016/j.endoen.2012.07.004</a>]</li>
-  <li>Moretti, C. G., Guccione, L., Di Giacinto, P., Cannuccia, A., Meleca, C., Lanzolla, G., Andreadi, A., &amp; Lauro, D. (2016). Efficacy and Safety of Myo-Inositol Supplementation in the Treatment of Obese Hirsute PCOS Women: Comparative Evaluation with OCP+Bicalutamide Therapy. <em>Endocrine Reviews</em>, <em>37</em>(2 Suppl 1) (SUN-153). [<a href="https://endo.confex.com/endo/2016endo/webprogram/Paper26631.html">URL</a>] [DOI:<a href="https://doi.org/10.1093/edrv/37.supp.1">10.1093/edrv/37.supp.1</a>]</li>
+  <li>Moretti, C. G., Guccione, L., Di Giacinto, P., Cannuccia, A., Meleca, C., Lanzolla, G., Andreadi, A., &amp; Lauro, D. (2016). Efficacy and Safety of Myo-Inositol Supplementation in the Treatment of Obese Hirsute PCOS Women: Comparative Evaluation with OCP+Bicalutamide Therapy. <em>Endocrine Reviews</em>, <em>37</em>(2 Suppl 1), ?–? (abstract no. SUN-153). [<a href="https://web.archive.org/web/20221108144934/https://endo.confex.com/endo/2016endo/webprogram/Paper26631.html">URL</a>] [DOI:<a href="https://doi.org/10.1093/edrv/37.supp.1">10.1093/edrv/37.supp.1</a>]</li>
   <li>Moretti, C., Guccione, L., Di Giacinto, P., Simonelli, I., Exacoustos, C., Toscano, V., Motta, C., De Leo, V., Petraglia, F., &amp; Lenzi, A. (2018). Combined oral contraception and bicalutamide in polycystic ovary syndrome and severe hirsutism: a double-blind randomized controlled trial. <em>The Journal of Clinical Endocrinology &amp; Metabolism</em>, <em>103</em>(3), 824–838. [DOI:<a href="https://doi.org/10.1210/jc.2017-01186">10.1210/jc.2017-01186</a>]</li>
   <li>Moussa, A., Kazmi, A., Bokhari, L., &amp; Sinclair, R. D. (2022). Bicalutamide improves minoxidil-induced hypertrichosis in female pattern hair loss: A retrospective review of 35 patients. <em>Journal of the American Academy of Dermatology</em>, <em>87</em>(2), 488–490. [DOI:<a href="https://doi.org/10.1016/j.jaad.2021.10.048">10.1016/j.jaad.2021.10.048</a>]</li>
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@@ -4749,7 +4770,7 @@ Using the term desistence in this way does not imply anything about the identity
   <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., &amp; 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>
   <li>van Kemenade, J. F., Cohen-Kettenis, P. T., Cohen, L., &amp; 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>
   <li>Vierregger, K., Tetzlaff, M., Zimmerman, B., Dunn, N., Finney, N., Lewis, K., Slomoff, R., &amp; 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>
-  <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>
-  <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>
+  <li>Vierregger, K. S. (2023). Bicalutamide Use as Antiandrogen in Trans Feminine Adults - A Safety Profile. <em>USPATH Scientific Symposium, November 1-5, 2023, The Westin Westminster, Westminster, Colorado, Abstract Submissions</em>, 96–96 (abstract no. SAT-B2-T4). [<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>] [<a href="https://files.transfemscience.org/pdfs/Vierregger%20et%20al.%20(2023)%20-%20Bicalutamide%20Use%20as%20Antiandrogen%20in%20Trans%20Feminine%20Adults%20-%20A%20Safety%20Profile%20(USPATH%202023,%20abstract%20no.%20SAT-B2-T4).pdf">PDF</a>] [<a href="https://files.transfemscience.org/pdfs/wpath-symposia-materials/USPATH%202023%20Symposium%20Abstracts.pdf#page=96">Full Abstract Book</a>]</li>
+  <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 Scientific Symposium, November 1-5, 2023, The Westin Westminster, Westminster, Colorado, Abstract Submissions</em>, 124–124 (abstract no. SUN-B1-T5). [<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>] [<a href="https://files.transfemscience.org/pdfs/Warus%20et%20al.%20(2023)%20-%20Safety%20of%20Bicalutamide%20as%20Anti-Androgenic%20Therapy%20in%20Gender%20Affirming%20Care%20for%20Adolescents%20and%20Young%20Adults_%20A%20Retrospective%20Chart%20Review%20(USPATH%202023,%20abstract%20no.%20SUN-B1-T5).pdf">PDF</a>] [<a href="https://files.transfemscience.org/pdfs/wpath-symposia-materials/USPATH%202023%20Symposium%20Abstracts.pdf#page=124">Full Abstract Book</a>]</li>
   <li>Wilde, B., Diamond, J. B., Laborda, T. J., Frank, L., O’Gorman, M. A., &amp; 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>]]></content><author><name>{&quot;first_name&quot;=&gt;&quot;Aly&quot;, &quot;last_name&quot;=&gt;&quot;W.&quot;, &quot;author-link&quot;=&gt;&quot;/about/#aly&quot;, &quot;articles-link&quot;=&gt;&quot;/articles-by-author/aly/&quot;}</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 23, 2024]]></summary></entry></feed>
+</ul>]]></content><author><name>{&quot;first_name&quot;=&gt;&quot;Aly&quot;, &quot;last_name&quot;=&gt;&quot;W.&quot;, &quot;author-link&quot;=&gt;&quot;/about/#aly&quot;, &quot;articles-link&quot;=&gt;&quot;/articles-by-author/aly/&quot;}</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 2, 2024]]></summary></entry></feed>