To evaluate the effects of cyproterone acetate versus spironolactone on breast development in transfeminine individuals undergoing gender-affirming hormone therapy.
Key Findings:
No statistically significant difference in breast development between cyproterone acetate and spironolactone (mean breast chest distance 0.27 cm, P = .6; estimated breast volume mean difference 17.26 mL, P = .3).
Cyproterone acetate was more effective in serum testosterone suppression, which may influence breast development outcomes.
No evidence of 'brain fog' was found in the study participants.
Interpretation:
The study suggests that cyproterone acetate does not provide additional benefits for breast development compared to spironolactone, despite its greater testosterone suppression, which is crucial for feminization.
Limitations:
Small sample size (n = 63).
Short duration of study (6 months).
Potential adverse effects of cyproterone acetate were not the focus of the study, and findings may not be generalizable to all transfeminine individuals.
Conclusion:
The findings indicate that cyproterone acetate may not be preferable to spironolactone for breast development in transfeminine hormone therapy, and treatment decisions should be individualized considering the lack of benefit and known risks associated with cyproterone acetate.
