CHICAGO – Novel findings unveiled at the 70th AACC Annual Scientific Meeting & Clinical Lab Expo show that gender-affirming hormone therapy markedly impacts the results of common laboratory tests for transgender patients. This study underscores the need for transgender-specific reference intervals to ensure this underserved population receives accurate diagnoses and effective treatments.
The fact that many medical protocols do not account for sex/gender incongruence is a significant barrier for transgender individuals seeking healthcare. In particular, for the nearly 50% of transgender individuals on hormone therapy, the medical field has yet to define reference intervals, which are the ranges of test result values observed in a healthy population that are used to determine whether individual lab results are normal or concerning. Without tailored reference intervals, test results for transgender patients on hormone therapy could indicate an underlying condition but go unrecognized if they are considered normal for cisgender individuals (those whose gender matches their assigned-at-birth sex). Conversely, if lab results for transgender patients fall outside of cisgender reference intervals, they could trigger unnecessary follow-up work even if the results are actually normal.
To help build the case for developing transgender reference intervals, a research team led by Jeff SoRelle, MD, of University of Texas Southwestern Medical Center in Dallas, investigated whether transgender patients on hormone therapy exhibit altered results for laboratory tests ordered during yearly check-ups. The study authors recorded lab values for a complete blood count, comprehensive metabolic panel, and lipid tests in 264 healthy transgender patients undergoing hormone therapy in transgender clinics from 2007 to 2017. Of these patients, 133 were taking estradiol to transition from male to female, and 89 were taking testosterone to transition from female to male. The scientists also gathered lab results for 149 transgender patients not undergoing hormone therapy to serve as a point of comparison.
From this, the researchers determined that both transgender women and men taking hormones displayed altered values for measures of red blood cell, kidney, and liver health. Transgender women taking hormones also had altered sodium, calcium, total protein, glucose, and platelet levels, while transgender men taking hormones displayed altered lipid values. Interpretation of these altered test results in the context of cisgender reference intervals could have serious consequences, from preventing diagnosis of anemia or kidney disease to affecting assessment of cardiovascular disease risk.
“Transgender patients will need their own reference ranges for several important parameters such as hemoglobin and creatinine,” said SoRelle. “It will also be important to determine whether proteins from cardiac muscle or the prostate, such as troponins or prostate specific antigen, are altered, too, which could affect diagnosis of heart attacks and prostate cancer.”
AACC Annual Scientific Meeting registration is free for members of the media. Reporters can register online here: https://www.xpressreg.net/register/aacc0718/media/start.asp.
Abstract B-189: Impact of cross-sex hormone therapy on common laboratory tests in transmen and transwomen will be presented during:
Scientific Poster Session
Wednesday, August 1
9:30 a.m. – 5 p.m. (presenting authors in attendance from 12:30 – 1:30 p.m.)
About the 70th AACC Annual Scientific Meeting & Clinical Lab Expo
The AACC Annual Scientific Meeting offers 5 days packed with opportunities to learn about exciting science from July 29–August 2. Plenary sessions feature the latest research on targeted cancer therapies, technology to define genetic defects, the HPV vaccine and associated cancers, using CRISPR to detect nucleic acid sequences, and the new WHO Essential Diagnostics List.
At the AACC Clinical Lab Expo, more than 800 exhibitors will fill the show floor of McCormick Place in Chicago with displays of the latest diagnostic technology, including but not limited to mobile health, molecular diagnostics, mass spectrometry, point-of-care, and automation.
Dedicated to achieving better health through laboratory medicine, AACC brings together more than 50,000 clinical laboratory professionals, physicians, research scientists, and business leaders from around the world focused on clinical chemistry, molecular diagnostics, mass spectrometry, translational medicine, lab management, and other areas of progressing laboratory science. Since 1948, AACC has worked to advance the common interests of the field, providing programs that advance scientific collaboration, knowledge, expertise, and innovation. For more information, visit www.aacc.org.