To assess the effect of cyproterone acetate and spironolactone on breast development in transgender individuals undergoing feminizing hormone therapy, focusing on the primary concern of breast development.
Key Findings:
No significant difference in breast–chest distance between cyproterone acetate and spironolactone groups (mean difference 0.27 cm, 95% CI -0.82 to 1.35, P = .6).
No significant difference in estimated breast volume (mean difference 17.26 mL, 95% CI -16.94 to 51.47, P = .3).
Cyproterone acetate was more effective in suppressing serum testosterone to <2 nmol/L (odds ratio 9.01, 95% CI 1.83 to 4.44, P = .008).
Changes in GPSQ scores were similar between both groups.
Interpretation:
The choice of antiandrogen should be based on clinician and patient preference, considering side effects and the similar breast development outcomes observed.
Limitations:
Small sample size (n=63) may limit generalizability of the findings.
Short duration of follow-up (6 months) may not capture long-term effects on breast development.
Conclusion:
Further research is needed to optimize breast development strategies in transgender individuals, as current findings suggest no significant advantage of cyproterone acetate over spironolactone in breast development, impacting clinical treatment choices.
