Keeping in mind that most children transitioning are female:
There is an increase in ovarian stromal tissue and cyst formation identical to the changes seen in polycystic ovarian syndrome. These changes occur after six months of therapy; their significance is unclear.
So not studied.
Testosterone induces the production of erythropoietin and so increases the production of red blood cells. Testosterone replacement therapy can be associated with polycythaemia and this increase in blood viscosity can lead to an increased incidence of stroke in those who have a haematocrit above 48%. This can occur even in young subjects; both stroke and myocardial infarction have been reported in anabolic steroid abusers.
The development of polycythaemia is more common with injectable forms of testosterone suggesting that the length of time that the testosterone concentration is supraphysiological is important in this effect. There are no reports on the incidence of polycythaemia in transmen receiving testosterone treatment in the current literature.
We've not studied this either.
Liver dysfunction and even fulminant hepatic failure have been reported as side-effects of testosterone therapy. This was, however, seen when alkylated anabolic steroid was used especially in the context of drugs of abuse by body builders and athletes. A very high incidence of liver dysfunction at 32% was reported when these compounds were used in transmen. Current treatment protocols do not use these anabolic steroids for testosterone replacement therapy.
There has been one series reporting the incidence of hepatic dysfunction in transmen treated with modern testosterone replacement therapy that reported the incidence of transient liver dysfunction (6 months) in 6.8%.28 It is commented in that report that no subject had liver enzyme dysfunction of more than 2.5 times the upper limit of normal; we can infer from that finding, that the disturbance was not great enough to merit cessation of therapy. Routine monitoring of the liver function in patients on testosterone replacement is recommended
6.8% risk. And 'infer'? infer??! as in we've guessed and not really studied properly infer?
Testosterone if used in excess, such as steroid abuse in athletes, increases insulin resistance; it had therefore been assumed that the high doses used in the masculinization of transmen would lead to an increase in insulin resistance. This does not appear to happen; in the only published study on this topic, insulin resistance did not change following one year of testosterone treatment
'This does not appear to happen; in the only published study on this topic, insulin resistance did not change following one year of testosterone treatment'. Erm what kind of science is this where we say this does not happen on the basis of a single year long study.
I was going to look through the whole report and comment, but I think I'll rest my case on this 'study' being not worth the paper its written on.
Thanks.