Short summary

Transgender men are persons who are assigned to the female sex at birth but identify as men. To relieve the gender dysphoria and distress, many transgender men initiate testosterone therapy in order to change sex from women to men. Information on changes in emotions is crucial in avoiding negative emotional and social consequences. Using monthly diary entries, we investigate how testosterone therapy affects emotions, thoughts and social relations through the first year of treatment.

Rationale

About 1% of the population, corresponding to more than 46.000 Danish adults, feel more like the other gender than the one they are assigned to at birth. Transgender men are persons who are assigned to the female sex at birth but identify as men. Transgender men suffer from gender dysphoria, which is distress from the mismatch between sex and gender identity. To relieve the gender dysphoria and distress, approximately 300 Danish transgender men seek medical care in order to change sex from women to men every year. The process of sex-change is often uncertain and unpredictable, leading to massive bodily and social changes. Testosterone therapy is essential for sex-change from woman to man. The therapy aims for a total testosterone level within the 95% reference interval for men, which is 12.5-37.6 nmol/l. The reference level is 0.35-1.97 nmol/l for biological women. Thus transgender men experience up to an 80-100-fold elevation in testosterone. The desired physical changes from testosterone therapy are well-defined: increase in muscle mass, bone density, libido, voice depth and hair growth. This is in contrast to the lack of information on the psychological and social changes. In addition to the desired physical changes, the goal of sex-change is to reduce the emotional problems associated with gender dysphoria, but not much is known on the effects on emotionality. Transgender men seem to experience elevated depression and anxiety. However, it is unclear whether these emotions are stable, or whether they change after testosterone initiation. Information on changes in emotions is crucial in avoiding negative emotional and social consequences. However, the existing knowledge on transgender emotionality is not sufficient for informing and supporting transgender patients and their relatives during testosterone therapy. In-depth knowledge of the experiences and impact on the everyday lives of the transgender men is virtually neglected. Hence, the aim of this sub-study is to investigate how testosterone therapy affects emotions, thoughts and social relations through the first year of treatment in transgender men. Further, we seek to investigate how and in what amount these changes is expressed in the daily living of our participants.

Description of the cohort

The study will include transgender men (assigned to the female sex at birth, but identifying as men) who are initiating gender affirming testosterone therapy in the setting of the Center for Gender Identity, Department of Endocrinology, Odense University Hospital

Data and biological material

Participants will inform us on background data (e.g. other diagnoses and current testosterone administration). The main data will be monthly diary entries of their daily living. This includes physical, psychological and social challenges, experiences and development.

Collaborating researchers and departments

Department of Psychology, SDU

• Kirsten Kaya Roessler
• Lotte Huniche