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Surgical and pharmacological reassignment: influence on transsexual cardiovascular risk profile
Author(s) -
Ciccone Marco M.,
Loverro Giuseppe,
Scicchitano Pietro,
Loverro Matteo,
Ricci Gabriella,
Scaramuzzi Francesca,
Gesualdo Michele,
Zito Annapaola,
Campagna Marcello,
Moncelli Michele,
Nicolardi Vittorio,
Manca Fabio,
Boninfante Barbara,
Carbonara Santa,
Cortese Francesca,
Todarello Orlando,
Bettocchi Carlo
Publication year - 2017
Publication title -
internal medicine journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.596
H-Index - 70
eISSN - 1445-5994
pISSN - 1444-0903
DOI - 10.1111/imj.13597
Subject(s) - medicine , brachial artery , transsexual , orchiectomy , hormone replacement therapy (female to male) , carotid arteries , group b , artery , group a , vasodilation , surgery , cardiology , transgender , testosterone (patch) , blood pressure , psychology , psychoanalysis
Background/Aim To evaluate and stratify early cardiovascular risk of transsexuals who underwent pharmacological and/or surgical gender reassignment. Methods Fifty‐six transsexuals were divided into two groups: group 1 – underwent gonadectomy (orchiectomy for transwomen and hystero‐annessiectomy for transmen); group 2 – hormone replacement therapy alone. All participants underwent carotid artery intima‐media thickness (C‐ IMT ) and flow‐mediated vasodilation ( FMD ) of brachial artery evaluations. Results FMD was lower in patients who had undergone gonadectomy compared with non‐surgically treated patients (Group 1: 5.711 vs Group 2: 7.339, P < 0.0001). Mean C‐ IMT was higher in group 1 than group 2 (group 1: 0.733 vs group 2: 0.582). The duration of hormone therapy correlates positively with mean C‐ IMT ( B = 0.001) and negatively with FMD (%) ( B = − 0.007). Conclusions Cardiovascular risk, which is expressed in terms of endothelial ( FMD ) and morphological (C‐ IMT ) dysfunction, increases in subjects undergoing gonadectomy compared with those receiving cross‐sex reassignment therapy alone.