Publication Date

5-2025

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Abstract

Objectives To evaluate the current perspective and clinical practices of physicians regarding the use of synthetic progestins as an adjunct to estrogen therapy in transfeminine adolescents. The survey focuses on perceived benefits, risks and overall efficacy in gender affirming hormone therapy. Methods A cross sectional survey was conducted among physicians who care for transfeminine patients. The survey included questions regarding their specialty, practice setting, age range of patients. Data was also collected regarding their indication for use, perceived benefits (e.g. breast development) and rationale if not using progestins for this purpose. Results Of 110 physicians who participated in the survey, 85 (77.2%) endorsed providing gender affirming care. Of those 85 respondents, 71(83.5%) have used progestins in some way, and 57 (67%) have used them as an adjunct to estrogen. Other uses included for contraception or amenorrhea in transmasculine patients, for suppression of endogenous puberty, and to induce patient requested hormone cycling. The most common form of progesterone used was oral progestin at 80.2% while depo medroxyprogesterone was used 21.1% Majority of the physicians (46/57, 80.7%) responded to being either somewhat satisfied or neutral to use of progestins. Of those who do not use progestins in transfeminine patients, most respondents noted lack of data on efficacy and side effects or lack of recommendations in guidelines. Others noted that it has not been necessary in achieving desired outcomes. Conclusions The survey indicates that while a significant number of physicians who practice gender affirming care incorporate progestins into hormone therapy for transgender youth, there was interest in more data on benefits and side effects on their use in transfeminine patients. Further research is needed to add to the current WPATH guideline to ensure more patient centric care along with ensuring its safety and effectiveness.

Disciplines

Endocrinology, Diabetes, and Metabolism | Pediatrics

Notes

Presented at the Pediatric Endocrine Society (PES) 2025 Annual Meeting; National Harbor, MD; May 15-18, 2025.

Physician Use of Progesterone in transgender adolescents: A survey

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