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Approach to Interpreting Common Laboratory Pathology Tests in Transgender Individuals
- Source :
- The Journal of Clinical Endocrinology and Metabolism
- Publication Year :
- 2020
- Publisher :
- The Endocrine Society, 2020.
-
Abstract
- Context As the number of transgender (trans) people (including those who are binary and/or nonbinary identified) seeking gender-affirming hormone therapy rises, endocrinologists are increasingly asked to assist with interpretation of laboratory tests. Many common laboratory tests such as hemoglobin, iron studies, cardiac troponin, and creatinine are affected by sex steroids or body size. We seek to provide a summary of the impact of feminizing and masculinizing hormone therapy on common laboratory tests and an approach to interpretation. Cases Case scenarios discussed include 1) hemoglobin and hematocrit in a nonbinary person undergoing masculinizing hormone therapy; 2) estimation of glomerular filtration rate in a trans woman at risk of contrast-induced nephropathy; 3) prostate-specific antigen (PSA) in a trans woman; and 4) chest pain in a trans man with a cardiac troponin concentration between the reported male and female reference ranges. Conclusions The influence of exogenous gender-affirming hormone therapy on fat and muscle distribution and other physiological changes determines interpretation of laboratory tests that have sex-specific differences. In addition to affirmative practice to ensure a patient’s name, gender, and pronoun are used appropriately, we propose that once individuals have commenced gender-affirming hormone therapy, the reference range of the affirmed gender be reported (and specified by treating clinicians) except for PSA or cardiac troponin, which are dependent on organ size. While suggestions may be challenging to implement, they also represent an opportunity to lead best practice to improve the quality of care and experiences of healthcare for all trans people.
- Subjects :
- Male
Pediatrics
Endocrinology, Diabetes and Metabolism
medicine.medical_treatment
Clinical Biochemistry
Hematocrit
Kidney Function Tests
Chest pain
Biochemistry
film.subject
0302 clinical medicine
Endocrinology
Reference Values
Transgender
Medicine
clinical laboratory information system
030212 general & internal medicine
reference range
Uncategorized
Trans woman
medicine.diagnostic_test
electronic health record
Middle Aged
transgender
Transgender hormone therapy
Heart Function Tests
Female
medicine.symptom
Artifacts
AcademicSubjects/MED00250
Adult
medicine.medical_specialty
Hormone Replacement Therapy
030209 endocrinology & metabolism
Context (language use)
Reference range
Transgender Persons
Diagnosis, Differential
Diagnostic Techniques, Endocrine
03 medical and health sciences
Commentaries
Internal medicine
Humans
Online Only Articles
Aged
Clinical Laboratory Techniques
business.industry
Biochemistry (medical)
film
Sex Reassignment Procedures
Hormone therapy
business
Transsexualism
Subjects
Details
- ISSN :
- 19457197 and 0021972X
- Volume :
- 106
- Database :
- OpenAIRE
- Journal :
- The Journal of Clinical Endocrinology & Metabolism
- Accession number :
- edsair.doi.dedup.....e7a7ccd5b2c23f6e904e33e99af4faf6
- Full Text :
- https://doi.org/10.1210/clinem/dgaa546