{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T03:52:09Z","timestamp":1792641129383,"version":"4.5.0"},"reference-count":24,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,11,7]],"date-time":"2023-11-07T00:00:00Z","timestamp":1699315200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Previous studies have shown differences in baseline and stimulated cortisol levels between men and women. Whether this difference is secondary to sex hormones or to other factors, such as genetic or epigenetic changes, is unknown. We investigated the effect of gender\u2010affirming hormone treatment (GAHT) on the hypothalamo\u2010pituitary\u2010adrenal axis\u00a0of transgender subjects in an effort to throw light on this question.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Ten transgender males (TM) and eight\u00a0transgender females (TF) underwent a low\u2010dose (1\u2009\u00b5g) adrenocorticotropic hormone (ACTH) stimulation test before and 6 months after GAHT initiation. Serum total, free and salivary cortisol (SC) levels were measured at baseline and at 20, 30\u00a0and 40\u2009min.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>For the TM, all three levels were significantly lower at several time points after ACTH injection compared to pretreatment levels following 6 months of treatment (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.05). Likewise, the overall SC\u00a0response as calculated by the area under the curve was significantly lower (<jats:italic>p<\/jats:italic>\u2009=\u2009.0053). For the TF, the basal total cortisol (TC) level increased after 6 months of treatment (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.01) while ACTH\u2010stimulated SC\u00a0levels decreased significantly. The basal ACTH levels were significantly lower following hormonal therapy (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Stimulated salivary cortisol levels decreased significantly after 6 months of GAHT in both male and female transgender subjects, possibly reflecting a decreased state of anxiety associated with treatment initiation. Additionally, basal and stimulated serum TC levels increased after hormonal treatment in the TF, probably secondary to the effect of oestrogen on cortisol\u2010binding globulin.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.14985","type":"journal-article","created":{"date-parts":[[2023,11,7]],"date-time":"2023-11-07T13:00:51Z","timestamp":1699362051000},"page":"164-169","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Gender\u2010affirming hormone therapy effect on cortisol levels in trans males and trans females"],"prefix":"10.1111","volume":"100","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2594-4553","authenticated-orcid":false,"given":"Yael","family":"Sofer","sequence":"first","affiliation":[{"name":"Institute of Endocrinology, Diabetes, Metabolism and Hypertension, Tel Aviv\u2010Sourasky Medical Center,\u00a0Affiliated to The Sackler Faculty of Medicine Tel Aviv University Tel Aviv 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