{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,6]],"date-time":"2026-09-06T09:38:03Z","timestamp":1788687483645,"version":"build-2803163510"},"reference-count":23,"publisher":"The Endocrine Society","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,8,18]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Concerns about future regret and treatment discontinuation have led to restricted access to gender-affirming medical treatment for transgender and gender-diverse (TGD) minors in some jurisdictions. However, these concerns are merely speculative because few studies have examined gender-affirming hormone continuation rates among TGD individuals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a secondary analysis of 2009 to 2018 medical and pharmacy records from the US Military Healthcare System. We identified TGD patients who were children and spouses of active-duty, retired, or deceased military members using International Classification of Diseases-9\/10 codes. We assessed initiation and continuation of gender-affirming hormones using pharmacy records. Kaplan-Meier and Cox proportional hazard analyses estimated continuation rates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The study sample included 627 transmasculine and 325 transfeminine individuals with an average age of 19.2\u2005\u00b1\u20055.3 years. The 4-year gender-affirming hormone continuation rate was 70.2% (95% CI, 63.9-76.5). Transfeminine individuals had a higher continuation rate than transmasculine individuals 81.0% (72.0%-90.0%) vs 64.4% (56.0%-72.8%). People who started hormones as minors had higher continuation rate than people who started as adults 74.4% (66.0%-82.8%) vs 64.4% (56.0%-72.8%). Continuation was not associated with household income or family member type. In Cox regression, both transmasculine gender identity (hazard ratio, 2.40; 95% CI, 1.50-3.86) and starting hormones as an adult (hazard ratio, 1.69; 95% CI, 1.14-2.52) were independently associated with increased discontinuation rates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Our results suggest that &amp;gt;70% of TGD individuals who start gender-affirming hormones will continue use beyond 4 years, with higher continuation rates in transfeminine individuals. Patients who start hormones, with their parents\u2019 assistance, before age 18 years have higher continuation rates than adults.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1210\/clinem\/dgac251","type":"journal-article","created":{"date-parts":[[2022,4,22]],"date-time":"2022-04-22T09:22:49Z","timestamp":1650619369000},"page":"e3937-e3943","source":"Crossref","is-referenced-by-count":80,"title":["Continuation of Gender-affirming Hormones Among Transgender Adolescents and Adults"],"prefix":"10.1210","volume":"107","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4966-7079","authenticated-orcid":false,"given":"Christina M","family":"Roberts","sequence":"first","affiliation":[{"name":"Division of Adolescent Medicine, Children\u2019s Mercy Kansas City , Kansas City, MO 64111 , USA"},{"name":"Department of Pediatrics, University of Missouri-Kansas City School of Medicine , Kansas City, MO 64111 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David A","family":"Klein","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Uniformed Services University , Bethesda, MD 20814 , USA"},{"name":"Department of Pediatrics, Uniformed Services University , Bethesda, MD 20814 , USA"},{"name":"Department of Family Medicine, David Grant Medical Center, Travis Air Force Base , CA 94533 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Terry A","family":"Adirim","sequence":"additional","affiliation":[{"name":"Department of Defense , Washington, DC 22042 , USA"},{"name":"Department of Preventive Medicine and Biostatistics, Uniformed Services University , Bethesda, MD 20814 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3136-6713","authenticated-orcid":false,"given":"Natasha A","family":"Schvey","sequence":"additional","affiliation":[{"name":"Department of Medical and Clinical Psychology, Uniformed Services University , Bethesda, MD 20814 , 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