ISSN 1662-4009 (online)

ESPE Yearbook of Paediatric Endocrinology (2022) 19 6.16 | DOI: 10.1530/ey.19.6.16

ESPEYB19 6. DSD and Gender Incongruence Gender Incongruence: Wider impacts of gender affirming hormone (GAH) treatments (3 abstracts)

6.16. Mortality trends over five decades in adult transgender people receiving hormone treatment: a report from the Amsterdam cohort of gender dysphoria

de Blok CJ , Wiepjes CM , van Velzen DM , Staphorsius AS , Nota NM , Gooren LJ , Kreukels BP & den Heijer M



Lancet Diabetes Endocrinol. 2021 Oct;9(10):663-670. PMID: 34481559, doi: 10.1016/S2213-8587(21)00185-6.

Brief Summary: This paper reports standardised mortality rates (SMR) between 1972 and 2018 in a large cohort of 2927 transgender women and 1641 transgender men from the Amsterdam Cohort of Gender Dysphoria. It finds a higher SMR for transgender women compared with transgender men.

As paediatricians, we should be aware of the long-term outcomes of our interventions. All of the current cohort started gender-affirming hormone (GAH) when aged > 17 years and none received GnRHa. The median follow-up time was 11 years (IQR 4–22) for transgender women and 5 years (2–17) for transgender men, giving a total follow-up time of 40,232 person-years for transgender women and 17,285 person-years for transgender men. No decreasing trend in mortality risk was observed over time.

317 (10·8%) transgender women died, higher than expected in comparison with the general population of cisgender men (SMR 1·8, 95% CI 1·6–2·0) and the general population of cisgender women (SMR 2·8, 2·5–3·1). Cause-specific mortality in transgender women was high for cardiovascular disease, lung cancer, HIV-related disease, and suicide. In transgender men, 44 (2·7%) died, which is also higher compared with the general population of cisgender women (SMR 1·8, 95% CI 1·3–2·4) but not when compared with the general population of cisgender men (SMR 1·2, 95% CI 0·9–1·6). Cause-specific death in transgender men, although fewer in total number than in transgender women, had a higher SMR high for non-natural causes of death other than suicide. There was no direct association found between GAH treatment types and the increased mortality.

These findings highlight the need for good general health advice and support for transgender people, and also reaffirm the need to study the long-term outcomes of GAH in transgender adolescents.

Article tools

My recent searches

No recent searches.