Transfem

3531 readers

26 users here now

A community for transfeminine people and experiences.

This is a supportive community for all transfeminine or questioning people. Anyone is welcome to participate in this community but disrupting the safety of this space for trans feminine people is unacceptable and will result in moderator action.

Debate surrounding transgender rights or acceptance will result in an immediate ban.

Please follow the rules of the lemmy.blahaj.zone instance.
Bigotry of any kind will not be tolerated.
Gatekeeping will not be tolerated.
Please be kind and respectful to all.
Please tag NSFW topics.
No NSFW image posts.
Please provide content warnings where appropriate.
Please do not repost bigoted content here.

This community is supportive of DIY HRT. Unsolicited medical advice or caution being given to people on DIY will result in moderator action.

Posters may express that they are looking for responses and support from groups with certain experiences (eg. trans people, trans people with supportive parents, trans parents.). Please respect those requests and be mindful that your experience may differ from others here.

To make such a request, at the start of the body of your post, not in the title, the first line should look like the this: [Requesting Engagement from _________]

Some helpful links:

The Gender Dysphoria Bible // In depth explanation of the different types of gender dysphoria.
Trans Voice Help // A community here on blahaj.zone for voice training.
LGBTQ+ Healthcare Directory // A directory of LGBTQ+ accepting Healthcare providers.
Trans Resistance Network // A US-based mutual aid organization to help trans people facing state violence and legal discrimination.
TLDEF's Trans Health Project // Advice about insurance claims for gender affirming healthcare and procedures.
TransLifeLine's ID change Library // A comprehensive guide to changing your name on any US legal document.
Gender Spectrum // Resources for youth, parents and family, educators, mental health professionals and faith leaders.

Support Hotlines:

The Trevor Project // Web chat, phone call, and text message LGBTQ+ support hotline.
TransLifeLine // A US/Canada LGBTQ+ phone support hotline service. The US line has Spanish support.
LGBT Youthline.ca // A Canadian LGBT hotline support service with phone call and web chat support. (4pm - 9:30pm EST)
988lifeline // A US only Crisis hotline with phone call, text and web chat support. Dedicated staff for LGBTQIA+ youth 24/7 on phone service, 3pm to 2am EST for text and web chat.

founded 2 years ago

MODERATORS

[email protected]

Sublingual Estradiol Offers No Apparent Advantage Over Combined Oral Estradiol and Cyproterone Acetate (pubmed.ncbi.nlm.nih.gov)

submitted 6 hours ago* (last edited 6 hours ago) by [email protected] to c/[email protected]

1 comments fedilink hide all child comments

Abstract

Purpose: Chronic gender-affirming hormone therapy (GAHT) with sublingual estradiol (SLE) has not been studied. We aimed to compare GAHT with SLE only, to combined oral (CO) estradiol and cyproterone acetate, in treatment-naive trans women.

Methods: Twenty-two trans women enrolled into either the CO arm or the SLE-only arm (0.5 mg four times daily) in this 6-month prospective study. Anthropometric and laboratory variables were collected at baseline and 3 and 6 months. At the study beginning and end, body composition was measured by dual-energy X-ray absorptiometry and bioelectrical impedance, and gender dysphoria, sexual desire, and function were assessed by validated questionnaires.

Results: Subjects in the SLE were older, 26.3±5.8 years versus 20.1±2.3 years, p=0.006. All anthropometric, body composition, and laboratory variables were identical at baseline. Although dysphoria appeared greater, and sexual function lower at baseline in the CO group, this canceled out after age adjustment. Both treatments induced similar biochemical and hormonal changes. Creatinine, hemoglobin and cholesterol decreased significantly, while testosterone was suppressed to the same level in both groups: 3.22 [1.47-5.0] nmol/L in the SLE group and 2.41 [0.55-8.5] nmol/L in the CO, p=0.65. Significant changes in body composition toward a more feminine body were noted in both groups. Dysphoria did not significantly improve in either group, while sexual desire and function decreased at six months in both, p<0.001.

Conclusions: Both treatments achieved similar clinical changes. At this stage, SLE, which repeatedly induces alarming excursions of serum estradiol throughout the day, appears to offer no advantage over the CO approach.

you are viewing a single comment's thread
view the rest of the comments

[–] [email protected] 8 points 3 hours ago* (last edited 3 hours ago)

I think this conclusion is incredibly naïve given the dramatically increased bioavailability and significantly decreased side effects that sublingual administration has over oral estradiol. Flooding the liver through oral administration results in strain that is significantly reduced by sublingual administration, and the increased bioavailability alone accounted for comparable testosterone suppression without an anti-androgen at the same daily dosage. So on top of the decrease in liver damage by moving away from oral administration, this approach also does not account for the side effects of the anti-androgen. The miniscule sample size doesn't do any favors to this study, either. The supposed "alarming excursions of serum estradiol" is solved simply by adjusting the dosage and spreading it out into more frequent doses throughout the day. It seems they did split the dosage into 4 doses for sublingual administration, but they are providing the same daily dosage despite significantly increased bioavailability of the sublingual route (which also accounts for the testosterone suppression). Additionally, a dosage of only 2mg of estradiol daily via oral administration is quite low for trans women.

I have a lot of problems with the conclusions of this study.

I'd like to link to a much more complete analysis of the sublingual route of administration for estradiol that analyzes a wide variety of sources (including the one linked in this post) for those interested in a more accurate picture of the benefits and shortcomings of sublingual administration:

An Exploration of Sublingual Estradiol as an Alternative to Oral Estradiol in Transfeminine People