MON-184 Androgen Concentrations, Metabolic And Mental Health Among Adolescents With Pcos With And Without Gender Incongruence

Abstract Disclosure: L. Chen: None. N. Nokoff: Neurocrine Biosciences, Inc, World Athletics. S. Bothwell: None. G. Carey: None. N. Morelli: None. T. Vigers: None. M.G. Cree: Novo Nordisk, Eli Lilly & Company. Background: The intersection of polycystic ovary syndrome (PCOS), a condition of excess testosterone, and gender incongruence (GI) remains underexplored, particularly regarding diagnostic and metabolic screening laboratory assessments and comorbid medical and psychiatric conditions. Objective: To compare underlying medical and psychiatric conditions, as well as hormonal profiles, in pediatric PCOS patients with GI versus matched cisgender PCOS controls. Methods: In this retrospective cross-sectional study at a single institution, we identified 47 pediatric (<18 years) PCOS patients with GI and matched them ∼1:2 by age, body mass index (BMI), and ethnicity to 92 cisgender females with PCOS without GI. We compared: (1) hormone profile (free/total testosterone, sex hormone binding globulin, androstenedione, 17-hydroxyprogesterone, DHEAS, LH, FSH), (2) metabolic screening labs (HbA1c, lipid panel, transaminases), (3) prevalence of comorbid medical and mental health conditions. Sex steroids are expressed as the percentage of the upper limit of normal (%ULN) for the specific assay. Sample sizes for each measurement vary based on differences in clinical documentation. Groups were compared with T-test or Wilcoxon for continuous variables and Chi-Squared or Fisher’s Exact for categorical variables. Results: There were no differences between the two groups in history of premature adrenarche, menarche age, hirsutism or acne severity. There were no significant differences in measures of androgenic hormones, SHBG, LH or FSH between groups. There were no significant differences in HbA1c, lipids or transaminases between groups. Individuals with GI had a significantly higher prevalence of a documented personal history of pre-diabetes (14.9 vs. 4.3%, p=0.044), hyperlipidemia (36.2 vs. 6.5%, p<0.0001), metabolic associated steatotic liver disease (14.9 vs 1.1%, p=0.002), anxiety (57.4 vs 17.4%, p<0.001), and depression (53.2 vs 23.9%, p<0.001). Conclusion: At the time of PCOS diagnosis, pediatric PCOS patients with GI exhibit similar hormonal profiles to those without GI, but have a higher prevalence of documented metabolic and psychiatric comorbidities. Future studies are needed to determine if there are true differences in prevalence or disparities in screening or documentation. Presentation: Monday, July 14, 2025