Physical and hormonal evaluation of transsexual patients: a longitudinal study

Arch Sex Behav. 1986 Apr;15(2):121-38. doi: 10.1007/BF01542220.


The physical and hormonal characteristics of 60 male-to-female transsexuals and 30 female-to-male transsexuals were measured before or during treatment with commonly used forms and dosages of hormones. Only two patients (both female-to-male) had either a congenital defect in hormonal production or abnormal genital development. Patients were seen at 3- to 6-month intervals for an average of 18 months. The response to therapy was examined over time; physical parameters, hormonal concentrations, liver function tests, lipids, and glucose were measured. Three patients were changed from ethinyl estradiol to conjugated estrogen because of liver enzyme elevations. Ethinyl estradiol (0.1-0.5 mg/day) was equal to conjugated estrogen (7.5-10 mg/day) in its ability to suppress testosterone and gonadotropins and to promote breast growth. Maximum breast growth required 2 years of therapy. During treatment with testosterone, female-to-male transsexuals had a significant mild elevation of cholesterol and triglyceride. The female-to-male transsexuals receiving testosterone cypionate, 200 mg every 2 weeks, ceased to have menstrual periods and became progressively masculinized. A mean maximal clitoral length of 4.6 cm which achieved by 1 year of therapy. Based on the data generated by this study, we recommend as hormonal therapy 0.1-0.5 mg/day of ethinyl estradiol or 7.5-10 mg/day of conjugated estrogen for male-to-female transsexuals, and intramuscular testosterone cypionate, 200 mg every 2 weeks, for female-to-male transsexuals.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Alanine Transaminase / blood
  • Aspartate Aminotransferases / blood
  • Cholesterol / blood
  • Drug Therapy, Combination
  • Estrogens, Conjugated (USP) / therapeutic use
  • Ethinyl Estradiol / therapeutic use
  • Female
  • Follicle Stimulating Hormone / blood*
  • Gonadal Steroid Hormones / blood*
  • Humans
  • Luteinizing Hormone / blood*
  • Male
  • Medroxyprogesterone / analogs & derivatives
  • Medroxyprogesterone / therapeutic use
  • Medroxyprogesterone Acetate
  • Middle Aged
  • Sex Characteristics*
  • Testosterone / analogs & derivatives
  • Testosterone / therapeutic use
  • Transsexualism / blood
  • Transsexualism / diagnosis*
  • Transsexualism / drug therapy
  • Triglycerides / blood


  • Estrogens, Conjugated (USP)
  • Gonadal Steroid Hormones
  • Triglycerides
  • Testosterone
  • Ethinyl Estradiol
  • Luteinizing Hormone
  • Follicle Stimulating Hormone
  • Cholesterol
  • Medroxyprogesterone Acetate
  • Aspartate Aminotransferases
  • Alanine Transaminase
  • Medroxyprogesterone
  • testosterone 17 beta-cypionate