The influence of gender-affirming hormone therapy on serum concentrations of hormone-binding proteins
Authors' conclusion
The GAHT led to an increase of CBG, TBG, and SHBG in estradiol users, more specifically oral estradiol, and to a decrease of SHBG, CBG, TBG, and IGF-BP3 in testosterone users. Recognizing these alterations is crucial for ensuring accurate hormone measurements and optimal patient care.
Study context
- Population
- Transfeminine and transmasculine persons starting gender-affirming hormone therapy (GAHT)
- Participants
- 41 vs 38
- Exposure
- Changes in hormone-binding proteins with GAHT in transfeminine and transmasculine persons
- Transfemininen = 41
- Transmasculinen = 38
- Outcome
- Serum CBG, TBG, SHBG and IGF-BP3 (percentage change, mixed models)
- Follow-up
- Baseline, 3 and 12 months
Main finding
As reported in the abstract
Percentage change in binding proteins
- Oral estradiol + CPA: Corticosteroid-binding globulin (CBG) change
- 29% (95% CI, 16, 44%)
- Oral estradiol + CPA: Thyroid-binding globulin (TBG) change
- 24% (95% CI, 16, 32%)
- Oral estradiol + CPA: Sex hormone-binding globulin (SHBG) change
- 81% (95% CI, 61, 105%)
- Oral estradiol + gonadotropin-releasing hormone analogs (GnRHa): CBG change
- 47% (95% CI, 7, 101%)
- Oral estradiol + GnRHa: TBG change
- 48% (95% CI, 9, 101%)
- Oral estradiol + GnRHa: SHBG change
- 242% (95% CI, 104, 474%)
- Transdermal estradiol + GnRHa: SHBG change (only SHBG changed)
- +63% [95% CI, 3, 157%]
- Transmasculine: CBG decrease
- 13% (95% CI, −21, −4%)
- Transmasculine: TBG decrease
- 11% (95% CI, −15, −6%)
- Transmasculine: SHBG decrease
- 43% (95% CI, −48, −36%)
- Transmasculine: IGF-BP3 decrease
- 10% (95% CI, −18, −2%)
Observational data: associations, not effects.
Original publication
The influence of gender-affirming hormone therapy on serum concentrations of hormone-binding proteins. Eur J Endocrinol. Published 16 May 2025. doi:10.
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