{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T10:15:47Z","timestamp":1791281747617,"version":"4.1.0"},"reference-count":32,"publisher":"The Endocrine Society","issue":"1","license":[{"start":{"date-parts":[[2024,5,30]],"date-time":"2024-05-30T00:00:00Z","timestamp":1717027200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000002","name":"NIH","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,12,18]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Context<\/jats:title>\n                  <jats:p>The long-term effect of gender-affirming hormone therapy (GAHT) on glucose metabolism is an area of priority in transgender health research.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To evaluate the relation between GAHT and changes in fasting blood glucose (FG) and glycosylated hemoglobin (HbA1c) in transmasculine (TM) and transfeminine (TF) persons relative to the corresponding temporal changes in presumably cisgender persons (ie, without any evidence of gender diversity).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>Retrospective cohort study.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting<\/jats:title>\n                  <jats:p>Three large integrated health systems.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Participants<\/jats:title>\n                  <jats:p>A total of 2148 TF and 1679 TM persons compared with 28 036 cisgender males and 32 548 cisgender females enrolled in the same health plans.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Outcomes\/measures<\/jats:title>\n                  <jats:p>Temporal changes in FG and HbA1c levels examined using linear mixed models with main results expressed as ratios-of-ratios.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The pre- vs post-GAHT ratios-of-ratio (95% CI) estimates adjusted for age, race\/ethnicity, study site, and body mass index in the model comparing TF and cisgender males groups were 1.05 (1.01-1.09) for FG and 1.03 (0.99-1.06) for HbA1c. By contrast, the corresponding results in the models contrasting TM and cisgender cohort members were in the 0.99 to 1.00 range. The ratio-of-ratios comparing post-GAHT changes among transgender and cisgender persons were close to the null and without a discernable pattern.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Though the within-transgender cohort data suggest an increase in the levels of FG and HbA1c following feminizing GAHT initiation, these changes were no longer evident when compared with the corresponding changes in cisgender referents. Based on these results, clinically important effects of GAHT on routine laboratory markers of glucose metabolism appear unlikely.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1210\/clinem\/dgae353","type":"journal-article","created":{"date-parts":[[2024,5,30]],"date-time":"2024-05-30T20:39:52Z","timestamp":1717101592000},"page":"289-296","source":"Crossref","is-referenced-by-count":2,"title":["Association Between Gender-affirming Hormone Therapy and Measures of Glucose Metabolism: A Longitudinal Study"],"prefix":"10.1210","volume":"110","author":[{"given":"Olivia","family":"Anike","sequence":"first","affiliation":[{"name":"Rollins School of Public Health, Emory University , Atlanta, GA 30322 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qi","family":"Zhang","sequence":"additional","affiliation":[{"name":"Rollins School of Public Health, Emory University , Atlanta, GA 30322 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3982-6200","authenticated-orcid":false,"given":"Shalender","family":"Bhasin","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital , Boston, MA 02115 ,","place":["USA"]},{"name":"Department of Medicine, Harvard School of Medicine , Boston, MA 02115 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W Dana","family":"Flanders","sequence":"additional","affiliation":[{"name":"Rollins School of Public Health, Emory University , Atlanta, GA 30322 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darios","family":"Getahun","sequence":"additional","affiliation":[{"name":"Department of Research and Evaluation, Kaiser Permanente Southern California , Pasadena, CA 91101 ,","place":["USA"]},{"name":"Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine , Pasadena, CA 91101 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J Sonya","family":"Haw","sequence":"additional","affiliation":[{"name":"Department of Medicine, Emory University School of Medicine , Atlanta, GA 30322 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krista F","family":"Huybrechts","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital , Boston, MA 02115 ,","place":["USA"]},{"name":"Department of Medicine, Harvard School of Medicine , Boston, MA 02115 ,","place":["USA"]},{"name":"Department of Epidemiology, Harvard T.H. Chan School of Public Health , Boston, MA 02115 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy L","family":"Lash","sequence":"additional","affiliation":[{"name":"Rollins School of Public Health, Emory University , Atlanta, GA 30322 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Courtney E","family":"McCracken","sequence":"additional","affiliation":[{"name":"Center for Research and Evaluation, Kaiser Permanente Georgia , Atlanta, GA 30309 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas","family":"Roblin","sequence":"additional","affiliation":[{"name":"Mid-Atlantic Permanente Research Institute, Kaiser Permanente Mid-Atlanta States , Rockville, MD 20852 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J","family":"Silverberg","sequence":"additional","affiliation":[{"name":"Division of Research, Kaiser Permanente, Northern California , Oakland, CA 94612 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shakira F","family":"Suglia","sequence":"additional","affiliation":[{"name":"Rollins School of Public Health, Emory University , Atlanta, GA 30322 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4021-5853","authenticated-orcid":false,"given":"Vin","family":"Tangpricha","sequence":"additional","affiliation":[{"name":"Department of Medicine, Emory University School of Medicine , Atlanta, GA 30322 ,","place":["USA"]},{"name":"The Atlanta VA Medical Center , Atlanta, GA 30033 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suma","family":"Vupputuri","sequence":"additional","affiliation":[{"name":"Mid-Atlantic Permanente Research Institute, Kaiser Permanente Mid-Atlanta States , Rockville, MD 20852 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6956-6879","authenticated-orcid":false,"given":"Michael","family":"Goodman","sequence":"additional","affiliation":[{"name":"Rollins School of Public Health, Emory University , Atlanta, GA 30322 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","published-online":{"date-parts":[[2024,5,30]]},"reference":[{"issue":"Suppl 1","key":"2025062417033693000_dgae353-B1","first-page":"S1","article-title":"Standards of care for the health of transgender and gender diverse people, version 8","volume":"23","author":"Coleman","year":"2022","journal-title":"Int J Transgend Health"},{"issue":"2","key":"2025062417033693000_dgae353-B2","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1080\/26895269.2020.1753136","article-title":"Epidemiological considerations in transgender health: a systematic review with focus on higher quality data","volume":"21","author":"Zhang","year":"2020","journal-title":"Int J Transgender Health"},{"issue":"1","key":"2025062417033693000_dgae353-B3","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1007\/s13178-017-0295-8","article-title":"Barriers to gender-affirming care for transgender and gender nonconforming individuals","volume":"15","author":"Puckett","year":"2018","journal-title":"Sex Res Social Policy"},{"issue":"10042","key":"2025062417033693000_dgae353-B4","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1016\/S0140-6736(16)00684-X","article-title":"Global health burden and needs of transgender populations: a review","volume":"388","author":"Reisner","year":"2016","journal-title":"Lancet"},{"issue":"4","key":"2025062417033693000_dgae353-B5","doi-asserted-by":"crossref","first-page":"e142029","DOI":"10.1172\/JCI142029","article-title":"Research gaps in medical treatment of transgender\/nonbinary people","volume":"131","author":"Safer","year":"2021","journal-title":"J Clin Invest"},{"issue":"4","key":"2025062417033693000_dgae353-B6","doi-asserted-by":"crossref","first-page":"556","DOI":"10.1001\/jamaoncol.2022.7173","article-title":"Cancer in transgender and gender-diverse persons: a review","volume":"9","author":"Leone","year":"2023","journal-title":"JAMA Oncol"},{"key":"2025062417033693000_dgae353-B7","doi-asserted-by":"crossref","first-page":"100173","DOI":"10.1016\/j.metop.2022.100173","article-title":"The effects of gender-affirming hormone therapy on cardiovascular and skeletal health: a literature review","volume":"13","author":"Chan Swe","year":"2022","journal-title":"Metabol Open"},{"issue":"11","key":"2025062417033693000_dgae353-B8","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"},{"issue":"6","key":"2025062417033693000_dgae353-B9","doi-asserted-by":"crossref","first-page":"877","DOI":"10.21037\/tau.2016.09.04","article-title":"Hormone therapy for transgender patients","volume":"5","author":"Unger","year":"2016","journal-title":"Transl Androl Urol"},{"issue":"4","key":"2025062417033693000_dgae353-B10","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1016\/S2213-8587(16)00036-X","article-title":"Testosterone therapy for transgender men","volume":"5","author":"Irwig","year":"2017","journal-title":"Lancet Diabetes Endocrinol"},{"issue":"2","key":"2025062417033693000_dgae353-B11","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1097\/MED.0000000000000231","article-title":"Priorities for transgender medical and healthcare research","volume":"23","author":"Feldman","year":"2016","journal-title":"Curr Opin Endocrinol Diabetes Obes"},{"issue":"1","key":"2025062417033693000_dgae353-B12","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1210\/er.2018-00011","article-title":"Endocrinology of transgender medicine","volume":"40","author":"T'Sjoen","year":"2019","journal-title":"Endocr Rev"},{"issue":"3","key":"2025062417033693000_dgae353-B13","doi-asserted-by":"crossref","first-page":"66","DOI":"10.4239\/wjd.v11.i3.66","article-title":"Effects of gender-affirming hormone therapy on insulin resistance and body composition in transgender individuals: a systematic review","volume":"11","author":"Spanos","year":"2020","journal-title":"World J Diabetes"},{"issue":"2","key":"2025062417033693000_dgae353-B14","doi-asserted-by":"crossref","first-page":"790","DOI":"10.1210\/jc.2017-01559","article-title":"Effects of sex hormone treatment on the metabolic syndrome in transgender individuals: focus on metabolic cytokines","volume":"103","author":"Auer","year":"2018","journal-title":"J Clin Endocrinol Metab"},{"issue":"4","key":"2025062417033693000_dgae353-B15","doi-asserted-by":"crossref","first-page":"e1549","DOI":"10.1210\/clinem\/dgab832","article-title":"Is there a link between hormone use and diabetes incidence in transgender people? Data from the STRONG cohort","volume":"107","author":"Islam","year":"2022","journal-title":"J Clin Endocrinol Metab"},{"issue":"5","key":"2025062417033693000_dgae353-B16","doi-asserted-by":"crossref","first-page":"e2000","DOI":"10.1210\/clinem\/dgab934","article-title":"Incident diabetes risk is not increased in transgender individuals using hormone therapy","volume":"107","author":"van Velzen","year":"2022","journal-title":"J Clin Endocrinol Metab"},{"issue":"12","key":"2025062417033693000_dgae353-B17","doi-asserted-by":"crossref","first-page":"e018121","DOI":"10.1136\/bmjopen-2017-018121","article-title":"Cohort profile: Study of Transition, Outcomes and Gender (STRONG) to assess health status of transgender people","volume":"7","author":"Quinn","year":"2017","journal-title":"BMJ Open"},{"issue":"11","key":"2025062417033693000_dgae353-B18","doi-asserted-by":"crossref","first-page":"bvaa119","DOI":"10.1210\/jendso\/bvaa119","article-title":"Longitudinal changes in hematologic parameters among transgender people receiving hormone therapy","volume":"4","author":"Antun","year":"2020","journal-title":"J Endocr Soc"},{"issue":"9","key":"2025062417033693000_dgae353-B19","doi-asserted-by":"crossref","first-page":"1662","DOI":"10.1016\/j.jsxm.2021.06.011","article-title":"Longitudinal changes in liver enzyme levels among transgender people receiving gender affirming hormone therapy","volume":"18","author":"Hashemi","year":"2021","journal-title":"J Sex Med"},{"key":"2025062417033693000_dgae353-B20","first-page":"E110","article-title":"Construction of a multisite DataLink using electronic health records for the identification, surveillance, prevention, and management of diabetes mellitus: the SUPREME-DM project","volume":"9","author":"Nichols","year":"2012","journal-title":"Prev Chronic Dis"},{"key":"2025062417033693000_dgae353-B21","unstructured":"Anike O, Zhang Q, Bhasin S, et al \u00a0Association between gender-affirming hormone therapy and measures of glucose metabolism: Supplemental Tables. figshare. 2024. 10.6084\/m9.figshare.25730811.v2"},{"issue":"2","key":"2025062417033693000_dgae353-B22","doi-asserted-by":"crossref","first-page":"411","DOI":"10.2337\/dc19-1061","article-title":"Effects of gender-affirming hormone therapy on insulin sensitivity and incretin responses in transgender people","volume":"43","author":"Shadid","year":"2020","journal-title":"Diabetes Care"},{"issue":"6","key":"2025062417033693000_dgae353-B23","doi-asserted-by":"crossref","first-page":"878","DOI":"10.1111\/cen.13821","article-title":"Testosterone undecanoate and testosterone enanthate injections are both effective and safe in transmen over 5 years of administration","volume":"89","author":"Gava","year":"2018","journal-title":"Clin Endocrinol (Oxf)"},{"issue":"4","key":"2025062417033693000_dgae353-B24","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1016\/j.jpsychores.2015.02.001","article-title":"Concomitant psychiatric problems and hormonal treatment induced metabolic syndrome in gender dysphoria individuals: a 2 year follow-up study","volume":"78","author":"Colizzi","year":"2015","journal-title":"J Psychosom Res"},{"issue":"6","key":"2025062417033693000_dgae353-B25","doi-asserted-by":"crossref","first-page":"725","DOI":"10.1111\/j.1745-7262.2006.00204.x","article-title":"Testosterone decreases adiponectin levels in female to male transsexuals","volume":"8","author":"Berra","year":"2006","journal-title":"Asian J Androl"},{"issue":"10","key":"2025062417033693000_dgae353-B26","doi-asserted-by":"crossref","first-page":"2442","DOI":"10.1111\/j.1743-6109.2008.00909.x","article-title":"Effects of testosterone undecanoate administered alone or in combination with letrozole or dutasteride in female to male transsexuals","volume":"5","author":"Meriggiola","year":"2008","journal-title":"J Sex Med"},{"issue":"12","key":"2025062417033693000_dgae353-B27","doi-asserted-by":"crossref","first-page":"3002","DOI":"10.1111\/jsm.12698","article-title":"Effects of three different testosterone formulations in female-to-male transsexual persons","volume":"11","author":"Pelusi","year":"2014","journal-title":"J Sex Med"},{"key":"2025062417033693000_dgae353-B28","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1016\/j.jsbmb.2017.05.010","article-title":"Effects of sex steroids on the pattern of methylation and expression of the promoter region of estrogen and androgen receptors in people with gender dysphoria under cross-sex hormone treatment","volume":"172","author":"Aranda","year":"2017","journal-title":"J Steroid Biochem Mol Biol"},{"issue":"5","key":"2025062417033693000_dgae353-B29","doi-asserted-by":"crossref","first-page":"562","DOI":"10.1046\/j.1365-2265.2003.01753.x","article-title":"Effects of sex steroids on components of the insulin resistance syndrome in transsexual subjects","volume":"58","author":"Elbers","year":"2003","journal-title":"Clin Endocrinol (Oxf)"},{"key":"2025062417033693000_dgae353-B30","doi-asserted-by":"crossref","first-page":"37005","DOI":"10.1038\/srep37005","article-title":"12-months metabolic changes among gender dysphoric individuals under cross-sex hormone treatment: a targeted metabolomics study","volume":"6","author":"Auer","year":"2016","journal-title":"Sci Rep"},{"key":"2025062417033693000_dgae353-B31","doi-asserted-by":"crossref","first-page":"2042018820985681","DOI":"10.1177\/2042018820985681","article-title":"Insulin resistance in transgender individuals correlates with android fat mass","volume":"12","author":"Bretherton","year":"2021","journal-title":"Ther Adv Endocrinol Metab"},{"issue":"3","key":"2025062417033693000_dgae353-B32","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1007\/s11154-018-9461-4","article-title":"Agreement between medical records and self-reports: implications for transgender health research","volume":"19","author":"Gerth","year":"2018","journal-title":"Rev Endocr Metab Disord"}],"container-title":["The Journal of Clinical Endocrinology &amp; Metabolism"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jcem\/advance-article-pdf\/doi\/10.1210\/clinem\/dgae353\/58757566\/dgae353.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jcem\/article-pdf\/110\/1\/289\/61213414\/dgae353.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jcem\/article-pdf\/110\/1\/289\/61213414\/dgae353.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,24]],"date-time":"2025-06-24T21:03:47Z","timestamp":1750799027000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jcem\/article\/110\/1\/289\/7685427"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,30]]},"references-count":32,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,5,30]]},"published-print":{"date-parts":[[2024,12,18]]}},"URL":"https:\/\/doi.org\/10.1210\/clinem\/dgae353","relation":{},"ISSN":["0021-972X","1945-7197"],"issn-type":[{"value":"0021-972X","type":"print"},{"value":"1945-7197","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,1]]},"published":{"date-parts":[[2024,5,30]]}}}