{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T04:51:55Z","timestamp":1792644715713,"version":"4.5.0"},"reference-count":58,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2020,7,20]],"date-time":"2020-07-20T00:00:00Z","timestamp":1595203200000},"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":[[2020,7,20]],"date-time":"2020-07-20T00:00:00Z","timestamp":1595203200000},"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":[[2020,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>As transmasculine persons utilize androgen gender affirming hormone therapy as a part of transition, guidance has been lacking on the effects of the therapy on the ovaries, especially for those who may desire retention.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Aim<\/jats:title>\n                  <jats:p>To describe the ovarian histopathology of transmasculine persons on testosterone therapy following oophorectomy at the time of hysterectomy performed for gender affirmation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This was a multicenter case series study of transmasculine patients on testosterone therapy who underwent hysterectomy with oophorectomy for gender affirmation between January 2015 and December 2017 at 5 tertiary care referral centers. Patients were identified by their current procedural and International Classification of Diseases codes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Outcomes<\/jats:title>\n                  <jats:p>Pre-, perioperative, and pathologic data were obtained from the electronic medical records and ovarian tissue descriptions from pathology reports were grouped into the following classifications: (i) simple\/follicular cysts; (ii) polycystic ovaries; (iii) complex cysts; (iv) endometriomas; (v) other masses; (vi) atrophy; and (vii) normal.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>85 patients were included in the study. At the time of oophorectomy, the mean age and body mass index of the cohort were 30.4 \u00b1 8.4 years and 30.2 \u00b1 7.3 kg\/m2, respectively, and the average interval from the initiation of testosterone to oophorectomy was 36 0.3 \u00b1 37.9 months. On examination of ovarian histopathology, 49.4% (42) of specimens were found to have follicular\/simple cysts, 5.9% (5) were polycystic, and 38.8% (33) had normal pathology. For those specimens with volume documented (n = 41), the median volume was 9.6 (range 1.5\u201382.5) cm3. There was no association between the duration of testosterone therapy or body mass index and the presence of cysts in the ovaries.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Clinical Implications<\/jats:title>\n                  <jats:p>The results of this study reported benign histopathology in ovaries of a large cohort of transmasculine persons on testosterone which should be included when counseling patients on ovarian retention, as transmasculine patients may choose to retain their ovaries while on testosterone for a variety of reasons (including no desire to undergo surgery, desire for backup sex steroids, and potential use for future fertility).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Strengths &amp; Limitations<\/jats:title>\n                  <jats:p>This is a large multicenter study seeking to address the uncertainty in present counseling surrounding ovarian conservation in transmasculine persons on testosterone therapy. Its limitations included its retrospective nature and inability to address ovarian function after testosterone discontinuance.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>In this cohort of transmasculine patients on testosterone therapy undergoing hysterectomy with oophorectomy for gender affirmation, ovarian histopathology was benign in all the specimens.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1016\/j.jsxm.2020.05.029","type":"journal-article","created":{"date-parts":[[2020,7,20]],"date-time":"2020-07-20T21:16:06Z","timestamp":1595279766000},"page":"1807-1818","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":56,"title":["Ovarian Histopathology in Transmasculine Persons on Testosterone: A Multicenter Case Series"],"prefix":"10.1093","volume":"17","author":[{"given":"Frances W.","family":"Grimstad","sequence":"first","affiliation":[{"name":"Division of Gynecology , Boston, MA , USA"},{"name":"Department of Surgery , Boston, MA , USA"},{"name":"Boston Children's Hospital , Boston, MA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kylie G.","family":"Fowler","sequence":"additional","affiliation":[{"name":"Department of Pediatric and Adolescent Gynecology , Minneapolis, MN , USA"},{"name":"Children's Hospitals and Clinics of Minnesota , Minneapolis, MN , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erika P.","family":"New","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology , Tampa, FL , USA"},{"name":"University of South Florida Morsani College of Medicine , Tampa, FL , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cecile A.","family":"Ferrando","sequence":"additional","affiliation":[{"name":"Center for Urogynecology and Pelvic Reconstructive Surgery , Cleveland, OH , USA"},{"name":"Center for LGBT Care , Cleveland, OH , USA"},{"name":"Cleveland Clinic , Cleveland, OH , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert R.","family":"Pollard","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology , Cleveland, OH , USA"},{"name":"University Hospitals Cleveland Medical Center\/MetroHealth Medical Center , Cleveland, OH , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Graham","family":"Chapman","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology , Cleveland, OH , USA"},{"name":"University Hospitals Cleveland Medical Center\/MetroHealth Medical Center , Cleveland, OH , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meredith","family":"Gray","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology , Kansas City, KS , USA"},{"name":"University of Kansas Medical Center , Kansas City, KS , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veronica","family":"Gomez Lobo","sequence":"additional","affiliation":[{"name":"Department of Pediatric and Adolescent Gynecology , Bethesda, MA , USA"},{"name":"National Institute for Child Health and Human Development , Bethesda, MA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,7,20]]},"reference":[{"key":"2023011111132542500_bib1","article-title":"The report of the 2015 US transgender survey","author":"James","year":"2016"},{"key":"2023011111132542500_bib2","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1080\/15532739.2011.700873","article-title":"Standards of care for the health of transsexual, transgender, and gender-nonconforming people, version 7","volume":"13","author":"Coleman","year":"2012","journal-title":"Int J Transgenderism"},{"key":"2023011111132542500_bib3","doi-asserted-by":"crossref","first-page":"3132","DOI":"10.1210\/jc.2009-0345","article-title":"Endocrine treatment of transsexual persons:an endocrine society clinical practice guideline","volume":"94","author":"Hembree","year":"2009","journal-title":"J Clin Endocrinol Metab"},{"key":"2023011111132542500_bib4","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1016\/j.ajog.2013.05.035","article-title":"Care of the transgender patient: the role of the gynecologist","volume":"210","author":"Unger","year":"2014","journal-title":"Am J Obstet Gynecol"},{"key":"2023011111132542500_bib5","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1016\/j.rbmo.2009.12.021","article-title":"Histology of genital tract and breast tissue after long-term testosterone administration in a female-to-male transsexual population","volume":"20","author":"Grynberg","year":"2010","journal-title":"Reprod Biomed Online"},{"key":"2023011111132542500_bib6","doi-asserted-by":"crossref","first-page":"714","DOI":"10.1097\/AOG.0000000000003472","article-title":"Barriers to evidence-based transgender care: knowledge gaps in gender-affirming hysterectomy and oophorectomy","volume":"134","author":"Reilly","year":"2019","journal-title":"Obstet Gynecol"},{"key":"2023011111132542500_bib7","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1097\/AOG.0000000000001866","article-title":"Feasibility of vaginal hysterectomy for female-to-male transgender men","volume":"129","author":"Obedin-Maliver","year":"2017","journal-title":"Obstet Gynecol"},{"key":"2023011111132542500_bib8","doi-asserted-by":"crossref","first-page":"653","DOI":"10.1016\/j.jadohealth.2020.03.012","article-title":"Empowering transmasculine youth by enhancing reproductive health counseling in the primary care setting","volume":"66","author":"Grimstad","year":"2020","journal-title":"J Adolesc Health"},{"key":"2023011111132542500_bib9","doi-asserted-by":"crossref","first-page":"1120","DOI":"10.1097\/AOG.0000000000000540","article-title":"Transgender men who experienced pregnancy after female-to-male gender transitioning","volume":"124","author":"Light","year":"2014","journal-title":"Obstet Gynecol"},{"key":"2023011111132542500_bib10","doi-asserted-by":"crossref","first-page":"2155","DOI":"10.1007\/s10815-019-01558-y","article-title":"Ovarian stimulation for fertility preservation or family building in a cohort of transgender men","volume":"36","author":"Adeleye","year":"2019","journal-title":"J Assist Reprod Genet"},{"key":"2023011111132542500_bib11","doi-asserted-by":"crossref","first-page":"858","DOI":"10.1016\/j.fertnstert.2019.07.014","article-title":"Assisted reproductive technology outcomes in female-to-male transgender patients compared with cisgender patients: a new frontier in reproductive medicine","volume":"112","author":"Leung","year":"2019","journal-title":"Fertil Steril"},{"key":"2023011111132542500_bib12","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1093\/humrep\/des385","article-title":"Excessive androgen exposure in female-to-male transsexual persons of reproductive age induces hyperplasia of the ovarian cortex and stroma but not polycystic ovary morphology","volume":"28","author":"Ikeda","year":"2013","journal-title":"Hum Reprod"},{"key":"2023011111132542500_bib13","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1097\/AOG.0000000000000692","article-title":"Effects of cross-sex hormone treatment on transgender women and men","volume":"125","author":"Deutsch","year":"2015","journal-title":"Obstet Gynecol"},{"key":"2023011111132542500_bib14","volume-title":"Guidelines for the Primary and Gender-Affirming Care of Transgender and Gender Nonbinary People","author":"UCSF Transgender Care, Department of Family and Community Medicine, University of California San Francisco","year":"2016","edition":"2nd ed."},{"key":"2023011111132542500_bib15","doi-asserted-by":"crossref","first-page":"3869","DOI":"10.1210\/jc.2017-01658","article-title":"Endocrine treatment of gender-dysphoric\/gender-incongruent persons: an endocrine society clinical practice guideline","volume":"102","author":"Hembree","year":"2017","journal-title":"J Clin Endocrinol Metab"},{"key":"2023011111132542500_bib16","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1089\/trgh.2017.0014","article-title":"Barriers to gender transition-related healthcare: identifying underserved transgender adults in Massachusetts","volume":"2","author":"White Hughto","year":"2017","journal-title":"Transgend Health"},{"key":"2023011111132542500_bib17","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1016\/j.jadohealth.2017.11.306","article-title":"Attitudes toward fertility and reproductive health among transgender and gender-nonconforming adolescents","volume":"63","author":"Chen","year":"2018","journal-title":"J Adolesc Health"},{"key":"2023011111132542500_bib18","doi-asserted-by":"crossref","first-page":"350","DOI":"10.1016\/j.whi.2018.03.002","article-title":"Reproductive health care priorities and barriers to effective care for LGBTQ people assigned female at birth: a qualitative study","volume":"28","author":"Wingo","year":"2018","journal-title":"Womens Health Issues"},{"key":"2023011111132542500_bib19","doi-asserted-by":"crossref","first-page":"1119","DOI":"10.1080\/13691058.2015.1042919","article-title":"Imagining parenthood: the possibilities and experiences of parenthood among transgender people","volume":"17","author":"von Doussa","year":"2015","journal-title":"Cult Health Sex"},{"key":"2023011111132542500_bib20","doi-asserted-by":"crossref","first-page":"257.e1","DOI":"10.1016\/j.ajog.2018.12.021","article-title":"Uterine pathology in transmasculine persons on testosterone: a retrospective multicenter case series","volume":"220","author":"Grimstad","year":"2019","journal-title":"Am J Obstet Gynecol"},{"key":"2023011111132542500_bib21","article-title":"Histology for pathologists","author":"Mills","year":"2012","edition":"4th ed"},{"key":"2023011111132542500_bib22","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1016\/j.jbi.2008.08.010","article-title":"Research electronic data capture (REDCap)--a metadata-driven methodology and workflow process for providing translational research informatics support","volume":"42","author":"Harris","year":"2009","journal-title":"J Biomed Inform"},{"key":"2023011111132542500_bib23","doi-asserted-by":"crossref","first-page":"103208","DOI":"10.1016\/j.jbi.2019.103208","article-title":"The REDCap consortium: building an international community of software platform partners","volume":"95","author":"Harris","year":"2019","journal-title":"J Biomed Inform"},{"key":"2023011111132542500_bib24","article-title":"SPSS statistics for Mac","author":"SPSS Inc","year":"2017"},{"key":"2023011111132542500_bib25","doi-asserted-by":"crossref","first-page":"520","DOI":"10.1097\/PGP.0000000000000548","article-title":"Histologic features of hysterectomy specimens from female-male transgender individuals","volume":"38","author":"Khalifa","year":"2019","journal-title":"Int J Gynecol Pathol"},{"key":"2023011111132542500_bib26","doi-asserted-by":"crossref","first-page":"1449","DOI":"10.1007\/s10815-017-0976-5","article-title":"Fertility preservation for trans men: frozen-thawed in vitro matured oocytes collected at the time of ovarian tissue processing exhibit normal meiotic spindles","volume":"34","author":"Lierman","year":"2017","journal-title":"J Assist Reprod Genet"},{"key":"2023011111132542500_bib27","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1089\/jwh.2014.4918","article-title":"Care of the transgender patient: a survey of gynecologists\u2019 current knowledge and practice","volume":"24","author":"Unger","year":"2015","journal-title":"J Womens Health (Larchmt)"},{"key":"2023011111132542500_bib28","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1016\/j.jmig.2016.12.010","article-title":"Impact of cystectomy on ovarian reserve: review of the literature","volume":"24","author":"Alammari","year":"2017","journal-title":"J Minim Invasive Gynecol"},{"key":"2023011111132542500_bib29","article-title":"Emans, laufer, goldstein\u2019s pediatric and adolescent gynecology","author":"Emans","year":"2012"},{"key":"2023011111132542500_bib30","first-page":"384","article-title":"Decrease in the size of ovarian endometriomas during ovarian suppression in stage IV endometriosis. Role of preoperative medical treatment","volume":"41","author":"Rana","year":"1996","journal-title":"J Reprod Med"},{"key":"2023011111132542500_bib31","first-page":"219","article-title":"Human postmenopausal ovary--hormonally inactive fibrous connective tissue or more?","volume":"23","author":"Laszczy\u0144ska","year":"2008","journal-title":"Histol Histopathol"},{"key":"2023011111132542500_bib32","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1016\/0378-5122(95)00985-X","article-title":"The normal menopause transition: an overview","volume":"23","author":"McKinlay","year":"1996","journal-title":"Maturitas"},{"key":"2023011111132542500_bib33","doi-asserted-by":"crossref","first-page":"686","DOI":"10.1016\/j.tjog.2016.03.004","article-title":"Uterine and ovarian changes during testosterone administration in young female-to-male transsexuals","volume":"55","author":"Loverro","year":"2016","journal-title":"Taiwan J Obstet Gynecol"},{"key":"2023011111132542500_bib34","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1210\/jcem-69-1-151","article-title":"The effects of long term testosterone administration on pulsatile luteinizing hormone secretion and on ovarian histology in eugonadal female to male transsexual subjects","volume":"69","author":"Spinder","year":"1989","journal-title":"J Clin Endocrinol Metab"},{"key":"2023011111132542500_bib35","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1210\/jcem-62-1-16","article-title":"Histopathological effects of exogenously administered testosterone in 19 female to male transsexuals","volume":"62","author":"Futterweit","year":"1986","journal-title":"J Clin Endocrinol Metab"},{"key":"2023011111132542500_bib36","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1111\/j.1365-2559.1991.tb00235.x","article-title":"Ovarian morphology in long-term androgen-treated female to male transsexuals. A human model for the study of polycystic ovarian syndrome?","volume":"19","author":"Pache","year":"1991","journal-title":"Histopathology"},{"key":"2023011111132542500_bib37","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1016\/S0015-0282(16)49155-7","article-title":"The effects of long-term androgen treatment on the ovary","volume":"45","author":"Amirikia","year":"1986","journal-title":"Fertil Steril"},{"key":"2023011111132542500_bib38","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1016\/j.endonu.2014.01.010","article-title":"Prevalence of hyperandrogenism and polycystic ovary syndrome in female to male transsexuals","volume":"61","author":"Becerra-Fern\u00e1ndez","year":"2014","journal-title":"Endocrinol Nutr"},{"key":"2023011111132542500_bib39","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1093\/humupd\/dmg044","article-title":"Ultrasound assessment of the polycystic ovary: international consensus definitions","volume":"9","author":"Balen","year":"2003","journal-title":"Hum Reprod Update"},{"key":"2023011111132542500_bib40","doi-asserted-by":"crossref","first-page":"765","DOI":"10.6061\/clinics\/2015(11)09","article-title":"Treatment of infertility in women with polycystic ovary syndrome: approach to clinical practice","volume":"70","author":"Melo","year":"2015","journal-title":"Clinics (Sao Paulo)"},{"key":"2023011111132542500_bib41","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1093\/humrep\/deh098","article-title":"Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS)","volume":"19","year":"2004","journal-title":"Hum Reprod"},{"key":"2023011111132542500_bib42","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1016\/j.fertnstert.2013.11.002","article-title":"Fertility in patients with congenital adrenal hyperplasia","volume":"101","author":"Reichman","year":"2014","journal-title":"Fertil Steril"},{"key":"2023011111132542500_bib43","doi-asserted-by":"crossref","first-page":"570","DOI":"10.1016\/S1472-6483(10)61165-0","article-title":"Impact of androgens on fertility - physiological, clinical and therapeutic aspects","volume":"11","author":"Hugues","year":"2005","journal-title":"Reprod Biomed Online"},{"key":"2023011111132542500_bib44","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1111\/j.1365-2265.1992.tb02266.x","article-title":"17 beta-Oestradiol, androstenedione and inhibin levels in fluid from individual follicles of normal and polycystic ovaries, and in ovaries from androgen treated female to male transsexuals","volume":"36","author":"Pache","year":"1992","journal-title":"Clin Endocrinol (Oxf)"},{"key":"2023011111132542500_bib45","doi-asserted-by":"crossref","first-page":"1340","DOI":"10.1016\/j.fertnstert.2015.02.003","article-title":"Antim\u00fcllerian hormone levels decrease in female-to-male transsexuals using testosterone as cross-sex therapy","volume":"103","author":"Caanen","year":"2015","journal-title":"Fertil Steril"},{"key":"2023011111132542500_bib46","first-page":"1328","article-title":"Ovarian hyperandrogynism as a result of congenital adrenal virilizing disorders: evidence for perinatal masculinization of neuroendocrine function in women","volume":"79","author":"Barnes","year":"1994","journal-title":"J Clin Endocrinol Metab"},{"key":"2023011111132542500_bib47","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1016\/0002-9378(81)90611-6","article-title":"Danazol: endocrine pharmacology and therapeutic applications","volume":"141","author":"Barbieri","year":"1981","journal-title":"Am J Obstet Gynecol"},{"key":"2023011111132542500_bib48","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1016\/S0015-0282(16)46331-4","article-title":"Danazol in the treatment of endometriosis: analysis of 100 cases with a 4-year follow-up","volume":"37","author":"Barbieri","year":"1982","journal-title":"Fertil Steril"},{"key":"2023011111132542500_bib49","first-page":"541","article-title":"Effect of danazol on the pregnancy rate in patients with unsuccessful in vitro fertilization-embryo transfer","volume":"43","author":"Tei","year":"1998","journal-title":"J Reprod Med"},{"key":"2023011111132542500_bib50","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1097\/AOG.0000000000001592","article-title":"Salpingo-oophorectomy at the time of benign hysterectomy: a systematic review","volume":"128","author":"Evans","year":"2016","journal-title":"Obstet Gynecol"},{"key":"2023011111132542500_bib51","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1097\/01.AOG.0000167394.38215.56","article-title":"Ovarian conservation at the time of hysterectomy for benign disease","volume":"106","author":"Parker","year":"2005","journal-title":"Obstet Gynecol"},{"key":"2023011111132542500_bib52","article-title":"The desire to have children and the preservation of fertility in transsexual women: a survey","volume":"6","author":"De Sutter","year":"2002","journal-title":"Int J Transgenderism"},{"key":"2023011111132542500_bib53","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1093\/humrep\/der406","article-title":"Reproductive wish in transsexual men","volume":"27","author":"Wierckx","year":"2012","journal-title":"Hum Reprod"},{"key":"2023011111132542500_bib54","doi-asserted-by":"crossref","first-page":"R201","DOI":"10.1530\/REP-15-0598","article-title":"Ovarian tissue transport to expand access to fertility preservation: from animals to clinical practice","volume":"152","author":"Duncan","year":"2016","journal-title":"Reproduction"},{"key":"2023011111132542500_bib55","doi-asserted-by":"crossref","first-page":"1152","DOI":"10.1001\/amajethics.2018.1152","article-title":"Infertility, inequality, and how lack of insurance coverage compromises reproductive autonomy","volume":"20","author":"Insogna","year":"2018","journal-title":"AMA J Ethics"},{"key":"2023011111132542500_bib56","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1016\/j.ecl.2019.02.003","article-title":"Fertility considerations in transgender persons","volume":"48","author":"Neblett","year":"2019","journal-title":"Endocrinol Metab Clin North Am"},{"key":"2023011111132542500_bib57","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1016\/j.jpeds.2018.09.009","article-title":"Understudied and under-reported: fertility issues in transgender youth\u2014a narrative review","volume":"205","author":"Nahata","year":"2019","journal-title":"J Pediatr"},{"key":"2023011111132542500_bib58","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1111\/j.1365-2265.1993.tb01013.x","article-title":"Polycystic ovaries are a common finding in untreated female to male transsexuals","volume":"38","author":"Balen","year":"1993","journal-title":"Clin Endocrinol"}],"container-title":["The Journal of Sexual Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1743609520306706?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1743609520306706?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/academic.oup.com\/jsm\/article-pdf\/17\/9\/1807\/48527519\/jsm_17_9_1807.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jsm\/article-pdf\/17\/9\/1807\/48527519\/jsm_17_9_1807.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,2,9]],"date-time":"2023-02-09T14:47:18Z","timestamp":1675954038000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jsm\/article\/17\/9\/1807\/6973863"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,7,20]]},"references-count":58,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2020,7,20]]},"published-print":{"date-parts":[[2020,9,1]]}},"URL":"https:\/\/doi.org\/10.1016\/j.jsxm.2020.05.029","relation":{},"ISSN":["1743-6109","1743-6095"],"issn-type":[{"value":"1743-6109","type":"electronic"},{"value":"1743-6095","type":"print"}],"subject":[],"published-other":{"date-parts":[[2020,9]]},"published":{"date-parts":[[2020,7,20]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Ovarian Histopathology in Transmasculine Persons on Testosterone: A Multicenter Case Series","name":"articletitle","label":"Article Title"},{"value":"The Journal of Sexual Medicine","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.jsxm.2020.05.029","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2020 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.","name":"copyright","label":"Copyright"}]}}