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Hematology reference intervals for transgender adults on stable hormone therapy
Dina N Greene1, Gabrielle Winston McPherson1, Jessica Rongitsch2
1Department of Laboratory Medicine, University of Washington, Seattle, WA, United States.
Clinica Chimica Acta; International Journal of Clinical Chemistry
|February 17, 2019
Summary
Hematology parameters for transgender individuals on hormone therapy align with cisgender reference ranges. This study establishes reference intervals, simplifying interpretation for transgender men and women.
Area of Science:
- Hematology
- Endocrinology
- Transgender Health
Background:
- Complete blood count (CBC) values vary by sex, requiring gender-specific reference intervals.
- Transgender individuals on hormone therapy often achieve hormone levels similar to cisgender individuals.
- Established gender-specific hematological reference intervals for transgender individuals are lacking.
Purpose of the Study:
- To establish clinically relevant hematological reference intervals for transgender individuals undergoing hormone therapy.
- To determine if transgender-specific reference intervals are needed for CBC parameters.
- To compare hematological values in transgender individuals with established cisgender reference ranges.
Main Methods:
- Recruited 79 transgender men on testosterone and 93 transgender women on estrogen for ≥12 months.
- Evaluated hemoglobin, hematocrit, MCV, MCHC, RDWCV, and cell counts (red, white, platelet).
- Interpreted results against overall distributions, hormone concentrations, and cisgender reference intervals.
Main Results:
- Hematology parameters in transgender individuals on hormone therapy were not clinically different from cisgender males and females, respectively.
- No significant difference was observed regardless of serum hormone concentration.
- Established cisgender reference intervals are applicable.
Conclusions:
- Transgender men and women on stable hormone therapy can be evaluated using cisgender male and female reference ranges, respectively.
- Concurrent sex hormone analysis is not required for interpreting these hematology values.
- Healthcare providers can confidently use standard reference ranges for transgender patients.
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