Monitoring and reporting of adverse effects of testosterone prescribing for gender affirmation at general practice clinics - Data from the PUSH! Audit

Beng Eu*, Joshua Dawe, Matthew Dunn, Julian Grace, Kevin Lee, Scott Griffiths, Mark Bloch, David Baker, Clara Soo, Fiona Bisshop, Mark Stoové

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

Abstract

Introduction
Prescribing testosterone for gender affirming hormone therapy (GAHT) has been increasing in Australia with much of this practice done by general practitioners (GPs) and there are current AusPATH guidelines on how this can be done appropriately. There has been limited data collected from GPs about how well these patients are monitored and the adverse effects (AEs) that are experienced by this population of patients.

Objectives
The primary objective of this study was to collect data about monitoring and adverse effects of GAHT provided in GP settings.

Methods
The PUSH! Audit was a cross-sectional study that collected data from 9 GP Clinics across 5 Australian cities who provided GAHT with testosterone. Data was also collected about cisgender men who were prescribed testosterone for testosterone deficiency (TD) as a comparison group (n = 209).

Results
The patients in the GAHT group (n = 277) tended to be younger (29.8 vs 54.9), with significant prevalence of smoking (21.8%) and anxiety/depression (37.2%) although this was not significantly higher that the comparison group. Most of the GAHT group had a testosterone level recorded in their file (90.6%) and the most common route of administration of testosterone was by intra-muscular injection (89.9%). The testosterone levels were mainly in the target range for males (75.7%) with only a small percentage registering levels above the target range (5.6%). Of the measured AEs, whilst there were significant prevalence of liver abnormalities and hypercholesterolemia, this was not significantly different to the TD group. The hypertension prevalence was lower in the GAHT group. Of the reported AEs, acne (10.1%) and balding (4.7%) were the only two AEs that were significantly reported.

Conclusion
This study shows that GAHT with testosterone can be provided effectively in general practice with high levels of success and very low levels of AEs.
Original languageEnglish
Number of pages8
JournalInternational Journal of Transgender Health
Early online date31 Oct 2023
DOIs
Publication statusE-pub ahead of print - 31 Oct 2023

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