Frances W Grimstad1, Elizabeth Boskey2, Meredith Grey3. 1. Division of Gynecology, Department of Surgery, Boston Children's Hospital, Boston, Massachusetts, USA. 2. Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, Massachusetts, USA. 3. Department of Obstetrics and Gynecology, University of Kansas Medical Center, Kansas City, Kansas, USA.
Abstract
Purpose: The purpose of this study was to provide a preliminary characterization of new-onset abdominopelvic pain reported by trans-masculine persons after initiation of testosterone gender-affirming hormone therapy (GAHT). Methods: From December 2015 to February 2017, an anonymous survey was distributed through social media, listservs, and community centers to trans-masculine persons, 18 years or older, on testosterone GAHT, who experienced new-onset abdominopelvic pain after initiating GAHT. Results: Of the 183 persons who completed the survey, 127 (69.4%) endorsed new-onset abdominopelvic pain since the initiation of testosterone GAHT. Median interval from testosterone initiation to pain onset was 1 year (range: 1 month to 20 years). The majority of respondents reported pain that was intermittent (79.5%), cramping in nature (75.6%), and localized to the suprapubic region (78.7%). Those with a uterus and ovaries were 9.50 times (95% confidence interval 2.85-31.66) more likely to endorse suprapubic localization (as opposed to other abdominopelvic regions). All 28 respondents who reported pain resolution with treatment, identified this treatment as a hysterectomy. Conclusion: In this preliminary evaluation of new-onset abdominopelvic pain experienced by trans-masculine persons after the initiation of testosterone GAHT, the combination of suprapubic localization of pain with self-reported effectiveness of hysterectomy as treatment suggests a reproductive organ etiology. Based on our data, clinicians should be aware of the possibility that trans-masculine persons may present for this concern. This study offers a starting point for research. Further prospective studies are necessary to evaluate the incidence, cause(s), and the most appropriate interventions.
Purpose: The purpose of this study was to provide a preliminary characterization of new-onset abdominopelvic pain reported by trans-masculine persons after initiation of testosterone gender-affirming hormone therapy (GAHT). Methods: From December 2015 to February 2017, an anonymous survey was distributed through social media, listservs, and community centers to trans-masculine persons, 18 years or older, on testosterone GAHT, who experienced new-onset abdominopelvic pain after initiating GAHT. Results: Of the 183 persons who completed the survey, 127 (69.4%) endorsed new-onset abdominopelvic pain since the initiation of testosterone GAHT. Median interval from testosterone initiation to pain onset was 1 year (range: 1 month to 20 years). The majority of respondents reported pain that was intermittent (79.5%), cramping in nature (75.6%), and localized to the suprapubic region (78.7%). Those with a uterus and ovaries were 9.50 times (95% confidence interval 2.85-31.66) more likely to endorse suprapubic localization (as opposed to other abdominopelvic regions). All 28 respondents who reported pain resolution with treatment, identified this treatment as a hysterectomy. Conclusion: In this preliminary evaluation of new-onset abdominopelvic pain experienced by trans-masculine persons after the initiation of testosterone GAHT, the combination of suprapubic localization of pain with self-reported effectiveness of hysterectomy as treatment suggests a reproductive organ etiology. Based on our data, clinicians should be aware of the possibility that trans-masculine persons may present for this concern. This study offers a starting point for research. Further prospective studies are necessary to evaluate the incidence, cause(s), and the most appropriate interventions.
Entities:
Keywords:
pelvic pain; sexual and gender minority; testosterone; trans male; trans-masculine; transgender man