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Gender-affirming hormone therapy in transgender women and risk of prostate cancer: pathophysiological mechanisms and clinical implications

Prostate Cancer and Prostatic Diseases (2024)Cite this article

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Gender-affirming hormone therapy (GAHT) for transgender women (TGW) transition is typically based on a combination of estrogens and androgen deprivation therapy [1]. This treatment is designed to recalibrate the hormonal balance in TGW.

GAHT promotes the development of female secondary sexual characteristics; in addition, it has a significant impact on mood, cognitive status, and behavior [2]. The biological and potentially pathological adaptations that male genitalia—particularly the prostate—undergo during the TGW transition remain unclear and source of several questions.

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Fig. 1: Potential biological mechanisms induced by gender-affirming hormone therapy on prostate cells.

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Authors and Affiliations

  1. Department of Urology, Rush University, Chicago, IL, USA

    Eugenio Bologna, Leslie Claire Licari, Antonio Franco, Francesco Ditonno, Riccardo Autorino & Celeste Manfredi

  2. Department of Maternal-Child and Urological Sciences, Sapienza University Rome, Policlinico Umberto I Hospital, Rome, Italy

    Eugenio Bologna & Leslie Claire Licari

  3. Department of Urology, Sant’Andrea Hospital, Sapienza University, Rome, Italy

    Antonio Franco & Cosimo De Nunzio

  4. Department of Urology, Azienda Ospedaliera Universitaria Integrata Verona, University of Verona, Verona, Italy

    Francesco Ditonno

  5. Department of Urology, “Regina Elena” National Cancer Institute, Rome, Italy

    Costantino Leonardo

  6. Unit of Urology, Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, Naples, Italy

    Celeste Manfredi

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  1. Eugenio Bologna
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Contributions

Conception and Design: EB and CM; Writing—original draft preparation: FD and AF; writing—review and editing: EB and LCL; Supervision: RA, CL and CD.

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Correspondence to Riccardo Autorino.

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Bologna, E., Licari, L.C., Franco, A. et al. Gender-affirming hormone therapy in transgender women and risk of prostate cancer: pathophysiological mechanisms and clinical implications. Prostate Cancer Prostatic Dis (2024). https://doi.org/10.1038/s41391-024-00796-1

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