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The following is a summary of “Continuation of Gender Affirming Hormone Therapy in Transgender and Gender Diverse Individuals: A Systematic Review,” published in the September 2024 issue of Endocrinology by Gupta et al.

Gender-affirming hormone therapy (GAHT) plays a pivotal role for transgender and gender diverse (TGD) individuals seeking to align their physical characteristics with their gender identity. Despite the increasing prevalence of GAHT, the rates of discontinuation and the factors contributing to such decisions remain inadequately understood. This systematic review aims to evaluate the continuation and discontinuation rates of GAHT and to identify the factors leading to its discontinuation through a comprehensive analysis of the existing literature. A systematic search was conducted on PubMed, covering the period from 2009 to April 1, 2024, focusing on studies that reported data related to the initiation, discontinuation, and reasons for discontinuation of GAHT. 

The screening process was carried out independently by two authors, including six studies published between 2021 and 2024 that met predefined inclusion and exclusion criteria. Among these, five studies reported GAHT discontinuation rates of less than 10%, indicating a generally low trend in discontinuation; however, one study documented significantly higher discontinuation or loss to follow-up rate of 30.8%. Notably, only one of the included studies utilized a prospective design, while the remainder were retrospective analyses. 

Additionally, the reasons for discontinuation were addressed in only two studies: one highlighted that discontinuation was primarily driven by external factors, while the other indicated that changes in an individual’s gender identity contributed to the decision to cease therapy. In conclusion, the current evidence suggests that rates of discontinuation of GAHT are relatively low; however, the reasons behind discontinuation are multifaceted, encompassing both external pressures and internal shifts in gender identity. There is a pressing need for further research to deepen the understanding of the internal and external factors that influence TGD individuals’ decisions regarding the continuation of GAHT. Future studies should aim to explore these dynamics comprehensively, providing valuable insights that can inform clinical practices and support systems for individuals undergoing GAHT.

Source: sciencedirect.com/science/article/abs/pii/S1530891X24006736