{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T20:59:07Z","timestamp":1779310747331,"version":"3.51.4"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2017,11,23]],"date-time":"2017-11-23T00:00:00Z","timestamp":1511395200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"},{"start":{"date-parts":[[2017,11,23]],"date-time":"2017-11-23T00:00:00Z","timestamp":1511395200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"}],"content-domain":{"domain":["jsm.jsexmed.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2018,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The acquisition of phenotypic male features in transmen with gender dysphoria requires testosterone treatment. The suppression of menses is 1 of the most desired effects. The relation between testosterone levels and human aggressive behavior has been described. However, the effects of testosterone on anger expression have been poorly investigated in trans-persons.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Aim<\/jats:title>\n                  <jats:p>To assess the effects of testosterone treatment on anger expression in transmen using a validated self-report questionnaire (Spielberger's State-Trait Anger Expression Inventory\u20132 [STAXI-2]).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>52 transmen diagnosed with gender dysphoria were evaluated before (T0) and at least 7 months after (T1) initiation of continuous gender-affirming testosterone treatment. Sociodemographic characteristics, anthropometric parameters, diagnosis of psychiatric disorders, current psychopharmacologic treatments, and life events were investigated at T0.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Outcomes<\/jats:title>\n                  <jats:p>STAXI-2 scores, serum testosterone, and estradiol levels at T0 and T1 were compared.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Most of the sample (61.5%, n\u00a0= 32) had no Axis I or II comorbidity. All subjects at T1 achieved significantly higher serum testosterone levels (5.67 \u00b1 3.88 ng\/mL), whereas no significant difference in estradiol levels was observed from T0 to T1. At T1 only 46.2% (n\u00a0= 24) of the sample achieved iatrogenic amenorrhea, whereas most of the sample had persistent regular bleedings. A significant increase in STAXI anger expression and anger control scores from T0 to T1 was recorded. Patients with persistent bleedings and Axis I disorders seemed to have higher odds of expressing anger. However, circulating testosterone levels at T1 did not influence anger expression.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Clinical Implications<\/jats:title>\n                  <jats:p>Interestingly, despite the increase of anger expression scores, during continuous testosterone treatment, there were no reports of aggressive behavior, self-harm, or psychiatric hospitalization.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Strengths and Limitations<\/jats:title>\n                  <jats:p>A limitation to this study is that although the STAXI-2 is a well-validated instrument measuring anger expression, it is a self-report psychometric measure.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>This study demonstrates that during 7 months of continuous gender-affirming hormonal treatment, anger expression and anger arousal control increased in transmen. Persistence of menstrual bleedings and Axis I disorders, but not circulating testosterone levels, were predictive of the increase in anger expression score. Continuous psychological support to transmen during gender-affirming hormonal treatment was useful to prevent angry behaviors and decrease the level of dysphoria.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1016\/j.jsxm.2017.11.004","type":"journal-article","created":{"date-parts":[[2017,11,27]],"date-time":"2017-11-27T13:47:05Z","timestamp":1511790425000},"page":"94-101","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":21,"title":["Does Testosterone Treatment Increase Anger Expression in a Population of Transgender Men?"],"prefix":"10.1093","volume":"15","author":[{"given":"Giovanna","family":"Motta","sequence":"first","affiliation":[{"name":"Division of Endocrinology, Diabetology and Metabolism , Turin \u00a0 Italy"},{"name":"Department of Medical Sciences , Turin \u00a0 Italy"},{"name":"University of Turin , Turin \u00a0 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