SUN-142 Preferences and Barriers to Hormone Replacement Therapy in the Transgender Population-Single Center Experience

Abstract Disclosure: S. Venugopal: None. S. Reddy: None. Introduction:Currently, no large clinical trials exist investigating the safety and efficacy in HRT used for gender transitioning. Henceforth, we have multiple recommendations for doses/modes of administration of hormones. We aimed to examine preferences and barriers to gender transitioning in a small, underserved clinic in Southern Maryland. We also looked into comorbidities associated with obesity in this population as well. Design/Methodology:We conducted a retrospective chart review of patients who carried a diagnosis of gender dysphoria between August 2023 and November 2024. We collected information including BMI, lipid panel, hemoglobin A1C, high blood pressure, diabetes or prediabetes, previous mental health professional notes/letters, previous use of HRT, and experience with HRT preparations. Results:The baseline characteristics showed that 6/10 patients (60 percent) had a BMI over 30, 6/10 (60%) had hyperlipidemia, 1/10 (10%) had hypertension, and 1/10 (10%) had pre-diabetes.70 % of the patients were female-to-male (FTM) and 30% were male-to-female (MTF).In regards to the HRT, our FTM patients (100%) preferred injections over patches. The majority of FTM 4/7 (57%) tried the patches first, and they did not achieve the desired masculinizing effects or experienced a side effect. The majority 4/7 (57%) were also using Testosterone injections every 2 weeks as opposed to every week 3/7 (43%).3/3 MTF ultimately chose estrogen pills as they tried patches and did not get the desired effects. One MTF was on additional oral micronized progesterone and she reported that her mood swings and breast development improved dramatically after the use of progesterone. The most common barrier was finding a local physician who prescribes HRT and longer wait times to access care. Most of our patients 6/10 (60%) were under the care of a mental health professional. Conclusion:From this small retrospective chart review, we conclude that for FTM, all our patients preferred the injections and the twice-weekly dosing. All the MTF patients were on pills. Most of these patients tried patches or gels and reported unwanted side effects or lack of desired masculinizing or feminizing effects with topical preparations. We need larger studies that can validate this and support injections as first-line therapy without trying topical preparations for Gender Affirming Therapy. We also need more quality studies on the use of newer progesterone preparations in MTF patients. Older studies (Medroxyprogesterone) do not support the use of progesterone as the risks outweigh the benefits. We need studies to evaluate the use of newer progesterone preparations in MTF to assess its safety and benefits. Presentation: Sunday, July 13, 2025