Injectable Estradiol Use in Transgender and Gender-Diverse Individuals throughout the United States - Summary - MDSpire

Injectable Estradiol Use in Transgender and Gender-Diverse Individuals throughout the United States

  • By

  • Aaron L Misakian

  • Carly E Kelley

  • Erika A Sullivan

  • Julia J Chang

  • Gagandeep Singh

  • Sarah Kokosa

  • Jonathan Avila

  • Holly Cooper

  • Jane W Liang

  • Bren Botzheim

  • Meg Quint

  • Athavi Jeevananthan

  • Ellenor Chi

  • Madison Harmer

  • Laurel Hiatt

  • Michaela Kowalewski

  • Benjamin Steinberg

  • Telisha Tausinga

  • Hannah Tanner

  • Tiffany F Ho

  • Bayarmaa Mark

  • Brian Zenger

  • Sophia Hu

  • Amanuail Gebregzabheir

  • Justin M Penny

  • Danielle F Loeb

  • Tyler Strickland

  • Sean J Iwamoto

  • Micol S Rothman

  • Ole-Petter R Hamnvik

  • Danit Ariel

  • January 11, 2025

  • 0 min

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Objective:

To determine the necessary dose of injectable estradiol to reach guideline-recommended estradiol concentrations for transgender and gender-diverse adults and to evaluate the relationship between estradiol concentration, timing/dose of injection, and other covariates such as age, body mass index, and duration of hormone therapy.

Key Findings:
  • Only 27.5% of patients reached guideline-recommended estradiol concentrations with a median dose of 4.0 mg, highlighting a significant gap in achieving optimal therapy.
  • The majority of patients had supraphysiologic estradiol concentrations (>200 pg/mL).
  • Timing and dose of injection significantly influenced estradiol concentrations.
  • No significant differences in dosing were found between IM and SC routes or between EC and EV esters.
Interpretation:

Injectable estradiol esters can achieve guideline-recommended estradiol concentrations at lower doses than previously suggested, with the timing of the last injection being crucial for interpreting estradiol levels, which may lead to revised clinical practices.

Limitations:
  • Retrospective design may introduce biases, such as selection bias and recall bias.
  • Data limited to specific medical centers may not represent broader populations.
  • Lack of recommendations for optimal timing of estradiol concentration checks.
Conclusion:

The study suggests that lower doses of injectable estradiol are effective in achieving desired estradiol concentrations in TGD individuals, emphasizing the importance of injection timing in monitoring therapy.

Original Source(s)

Injectable Estradiol Use in Transgender and Gender-Diverse Individuals throughout the United States

  • by Aaron L Misakian, Carly E Kelley, Erika A Sullivan, Julia J Chang, Gagandeep Singh, Sarah Kokosa, Jonathan Avila, Holly Cooper, Jane W Liang, Bren Botzheim, Meg Quint, Athavi Jeevananthan, Ellenor Chi, Madison Harmer, Laurel Hiatt, Michaela Kowalewski, Benjamin Steinberg, Telisha Tausinga, Hannah Tanner, Tiffany F Ho, Bayarmaa Mark, Brian Zenger, Sophia Hu, Amanuail Gebregzabheir, Justin M Penny, Danielle F Loeb, Tyler Strickland, Sean J Iwamoto, Micol S Rothman, Ole-Petter R Hamnvik, Danit Ariel

  • January 11, 2025

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