NCT02518009

Brief Summary

Gender dysphoria (DSM-5) or transsexualism (ICD10) is a condition in which a person's feeling of gender identity is not congruent with the physical body. The hormonal treatment includes inhibition of one's own sex hormone production followed by treatment with testosterone or estrogen levels that are normal for the opposite sex. Seen as experimental model, this is a process that provides an opportunity to study the sex hormone dependent influences that explain differences in morbidity in men and women respectively. The differences that are especially significant but not well known is 1) metabolic changes in the regulation of glucose homeostasis and lipid metabolism 2) regulation of vascular function and structural effects on the heart and arteries 3) regulation of skeletal muscle mass and fat tissue 4) morphological and functional effects on discrete areas of the brain. Therefore, the investigators will follow these patients for a year to study how the heart, blood vessels, brain, and risk factors for cardiovascular disease affected by altered sex hormone patterns and studying what happens in the muscles and fat in both the short and long term with respect to particular gene expression and epigenetic changes and link it to metabolic changes and body composition.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
40

participants targeted

Target at P25-P50 for all trials

Timeline
Completed

Started Apr 2015

Longer than P75 for all trials

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

April 1, 2015

Completed
1 month until next milestone

First Submitted

Initial submission to the registry

May 12, 2015

Completed
3 months until next milestone

First Posted

Study publicly available on registry

August 7, 2015

Completed
6.3 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

December 1, 2021

Completed
5 months until next milestone

Study Completion

Last participant's last visit for all outcomes

May 1, 2022

Completed
Last Updated

June 10, 2022

Status Verified

June 1, 2022

Enrollment Period

6.7 years

First QC Date

May 12, 2015

Last Update Submit

June 9, 2022

Conditions

Outcome Measures

Primary Outcomes (1)

  • Physiological changes in peripheral tissues

    Expression level and changes in epigenetics in skeletal muscle, skin and adipose tissue and associate to metabolism, insulin sensitivity, muscle strength, adipokines and adipose tissue morphology changes and body composition.

    5 years

Secondary Outcomes (5)

  • Arterial stiffness, endothelial function and structural and functional effects of the heart

    5 years

  • Regulation of skeletal muscle mass and fat tissue with effect on body composition

    5 years

  • Systemic immune system changes

    5 years

  • Metabolic changes in the regulation of glucose homeostasis and lipid metabolism

    5 years

  • Morphological and functional effects on discrete areas of the brain

    5 years

Study Arms (2)

Men with gender dysphoria

Genetic men treated with estrogen

Other: Genetic men treated with estrogen

Women with gender dysphoria

Genetic women treated with androgen

Other: Genetic women treated with androgen

Interventions

Observational during estrogen treatment

Men with gender dysphoria

Observational during androgen treatment

Women with gender dysphoria

Eligibility Criteria

Age20 Years - 40 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64)
Sampling MethodProbability Sample
Study Population

Subjects that are under investigation for gender dysphoria that have been accepted but not yet started their treatment with contrary sex hormones are asked if they want to participate.

You may qualify if:

  • Otherwise healthy

You may not qualify if:

  • Infectious disease
  • Treatment with Warfarin or other anti coagulants.
  • History of cardiovascular disease.
  • Serious illness or mental disorder.
  • Diabetes type 1
  • Language difficulties

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Karolinska Institutet

Stockholm, 14186, Sweden

Location

Related Publications (2)

  • Subramanian N, Wiik A, Rullman E, Melin M, Lundberg TR, Flanagan J, Holmberg M, Dekanski A, Dhejne C, Arver S, Gustafsson T, Laurencikiene J, Andersson DP. Adipokine secretion and lipolysis following gender-affirming treatment in transgender individuals. J Endocrinol Invest. 2024 Sep;47(9):2249-2260. doi: 10.1007/s40618-024-02323-4. Epub 2024 Mar 9.

  • Wiik A, Lundberg TR, Rullman E, Andersson DP, Holmberg M, Mandic M, Brismar TB, Dahlqvist Leinhard O, Chanpen S, Flanagan JN, Arver S, Gustafsson T. Muscle Strength, Size, and Composition Following 12 Months of Gender-affirming Treatment in Transgender Individuals. J Clin Endocrinol Metab. 2020 Mar 1;105(3):dgz247. doi: 10.1210/clinem/dgz247.

Biospecimen

Retention: SAMPLES WITH DNA

Tissue samples from blood, skin, muscle and fat

MeSH Terms

Conditions

Transsexualism

Interventions

EstrogensAndrogens

Condition Hierarchy (Ancestors)

SexualitySexual BehaviorBehavior

Intervention Hierarchy (Ancestors)

HormonesHormones, Hormone Substitutes, and Hormone AntagonistsPhysiological Effects of DrugsPharmacologic ActionsChemical Actions and Uses

Study Officials

  • Anna M Wiik, PhD

    Karolinska Institutet

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
observational
Observational Model
COHORT
Time Perspective
PROSPECTIVE
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
PhD, MD

Study Record Dates

First Submitted

May 12, 2015

First Posted

August 7, 2015

Study Start

April 1, 2015

Primary Completion

December 1, 2021

Study Completion

May 1, 2022

Last Updated

June 10, 2022

Record last verified: 2022-06

Locations