The Study of Transition, Outcomes, and Gender (STRONG) is a cohort study of health in transgender people before and during or after gender-affirming treatments such as gender-affirming hormone therapy and gender-affirming surgery. [1] It is being conducted at Kaiser Permanente sites in Northern California, Southern California, and Georgia and includes over 6,000 transgender people. [1] The study was underway by 2015 [2] and the first paper for the study was published in 2017. [1] The STRONG cohort represents the largest cohort of transgender people studied to date and the first such large-scale study conducted in the United States. [2]
STRONG has published papers assessing transgender population size and demographics, [3] agreement between electronic medical records and self-reported gender identity, [4] gender dysphoria and mental health, [5] [6] suicidality, [7] "passing" and mental health, [8] progression of gender dysphoria in transgender youth, [9] hematological parameters, [10] liver parameters, [11] acne risk, [12] [13] psoriasis risk, [14] cardiovascular health, [15] [16] diabetes risk, [17] [18] and cancer risk. [19]
The World Professional Association for Transgender Health (WPATH), formerly the Harry Benjamin International Gender Dysphoria Association (HBIGDA), is a professional organization devoted to the understanding and treatment of gender identity and gender dysphoria, and creating standardized treatment for transgender and gender variant people. WPATH was founded in 1979 and named HBIGDA in honor of Harry Benjamin during a period where there was no clinical consensus on how and when to provide gender-affirming care. WPATH is mostly known for the Standards of Care for the Health of Transgender and Gender Diverse People (SOC).
Gonadotropin-releasing hormone antagonists are a class of medications that antagonize the gonadotropin-releasing hormone receptor and thus the action of gonadotropin-releasing hormone (GnRH). They are used in the treatment of prostate cancer, endometriosis, uterine fibroids, female infertility in assisted reproduction, and for other indications.
Gender dysphoria in children (GD), also known as gender incongruence of childhood, is a formal diagnosis for children who experience significant discontent due to a mismatch between their assigned sex and gender identity. The diagnostic label gender identity disorder in children (GIDC) was used by the Diagnostic and Statistical Manual of Mental Disorders (DSM) until it was renamed gender dysphoria in children in 2013 with the release of the DSM-5. The diagnosis was renamed to remove the stigma associated with the term disorder.
Gender incongruence is the state of having a gender identity that does not correspond to one's sex assigned at birth. This is experienced by people who identify as transgender or transsexual, and often results in gender dysphoria. The causes of gender incongruence have been studied for decades.
In the context of gender, passing is when someone is perceived as a gender they identify as or are attempting to be seen as, rather than their sex assigned at birth. Historically, this was common among women who served in occupations where women were prohibited, such as in combat roles in the military. For transgender people, it is when the person is perceived as cisgender instead of the sex they were assigned at birth. For example, someone who is a transgender man is passing if he is perceived as a cisgender man.
Growth hormone receptor is a protein that in humans is encoded by the GHR gene. GHR orthologs have been identified in most mammals.
Thyroid hormone receptor beta (TR-beta) also known as nuclear receptor subfamily 1, group A, member 2 (NR1A2), is a nuclear receptor protein that in humans is encoded by the THRB gene.
Masculinizing hormone therapy, also known as transmasculine hormone therapy or female-to-male hormone therapy, is a form of hormone therapy and gender affirming therapy which is used to change the secondary sexual characteristics of transgender people from feminine or androgynous to masculine. It is a common type of transgender hormone therapy, and is predominantly used to treat transgender men and other transmasculine individuals who were assigned female at birth. Some intersex people also receive this form of therapy, either starting in childhood to confirm the assigned sex or later if the assignment proves to be incorrect.
Feminizing hormone therapy, also known as transfeminine hormone therapy, is hormone therapy and sex reassignment therapy to change the secondary sex characteristics of transgender people from masculine or androgynous to feminine. It is a common type of transgender hormone therapy and is used to treat transgender women and non-binary transfeminine individuals. Some, in particular intersex people, but also some non-transgender people, take this form of therapy according to their personal needs and preferences.
Thyroid receptor-interacting protein 11 is a protein that in humans is encoded by the TRIP11 gene.
The interleukin-23 receptor is a type I cytokine receptor. It is encoded in human by the IL23R gene. In complex with the interleukin-12 receptor β1 subunit (IL-12Rβ1), it is activated by the cytokine interleukin 23 (IL-23). The IL23R mRNA is 2.8 kilobases in length and includes 12 exons. The translated protein contains 629 amino acids; it is a type I penetrating protein and includes a signal peptide, an N-terminal fibronectin III-like domain and an intracellular part that contains three potential tyrosine phosphorylation domains. There are 24 IL23R splice variants in mitogen-activated lymphocytes. IL23R includes some single-nucleotide polymorphisms in the region encoding the domain that binds IL-23, which may lead to differences between people in Th17 activation. There is also a variant of IL-23R that consists of just the extracellular part and is known as soluble IL-23R. This form can compete with the membrane-bound form to bind IL-23, modulating the Th17 immune response and regulation of inflammation and immune function.
Transgender women are women who were assigned male at birth. Trans women have a female gender identity and may experience gender dysphoria. Gender dysphoria may be treated with gender-affirming care.
The sum activity of peripheral deiodinases is the maximum amount of triiodothyronine produced per time-unit under conditions of substrate saturation. It is assumed to reflect the activity of deiodinases outside the central nervous system and other isolated compartments. GD is therefore expected to reflect predominantly the activity of type I deiodinase.
Johanna Olson-Kennedy is an American physician who specializes in the care of children and teenagers with gender dysphoria and youth with HIV and chronic pain. She is board-certified in pediatrics and adolescent medicine and is the medical director of the Center for Transyouth Health and Development at Children's Hospital Los Angeles.
Puberty blockers are medicines used to postpone puberty in children. The most commonly used puberty blockers are gonadotropin-releasing hormone (GnRH) agonists, which suppress the natural production of sex hormones, such as androgens and estrogens. Puberty blockers are used to delay puberty in children with precocious puberty. They are also used to delay the development of unwanted secondary sex characteristics in transgender children, so as to allow transgender youth more time to explore their gender identity. The same drugs are also used in fertility medicine and to treat some hormone-sensitive cancers in adults.
Gender-affirming hormone therapy (GAHT), also called hormone replacement therapy (HRT) or transgender hormone therapy, is a form of hormone therapy in which sex hormones and other hormonal medications are administered to transgender or gender nonconforming individuals for the purpose of more closely aligning their secondary sexual characteristics with their gender identity. This form of hormone therapy is given as one of two types, based on whether the goal of treatment is masculinization or feminization:
Transgender pregnancy is the gestation of one or more embryos or fetuses by transgender people. As of 2024, the possibility is restricted to those born with female reproductive systems. However, transition-related treatments may impact fertility. Transgender men and nonbinary people who are or wish to become pregnant face social, medical, legal, and psychological concerns. As uterus transplantations are currently experimental, and none have successfully been performed on trans women, they cannot become pregnant.
Transgender health care includes the prevention, diagnosis and treatment of physical and mental health conditions for transgender individuals. A major component of transgender health care is gender-affirming care, the medical aspect of gender transition. Questions implicated in transgender health care include gender variance, sex reassignment therapy, health risks, and access to healthcare for trans people in different countries around the world. Gender affirming health care can include psychological, medical, physical, and social behavioral care. The purpose of gender affirming care is to help a transgender individual conform to their desired gender identity.
The European Network for the Investigation of Gender Incongruence (ENIGI) is a collaborative multicenter prospective cohort study on gender incongruence which started in 2010 and is being conducted by several transgender clinics in Europe. The clinics that have been involved in the initiative include the Center of Expertise on Gender Dysphoria (CEGD) at Amsterdam University Medical Centers, location VUmc in Amsterdam, Netherlands, the Center for Sexology and Gender at Ghent University Hospital in Ghent, Belgium, the University Medical Center Hamburg-Eppendorf in Hamburg, Germany, the Oslo University Hospital, Rikshospitalet in Oslo, Norway, and the University Hospital of the University of Florence in Florence, Italy. The clinics in the ENIGI initiative developed a common study and treatment protocol and maintain a shared database. The study includes an endocrine part to evaluate the effects of transgender hormone therapy in transfeminine and transmasculine people.
Lesbian, gay, bisexual, and transgender people people wishing to have children may use assisted reproductive technology. In recent decades, developmental biologists have been researching and developing techniques to facilitate same-sex reproduction.