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Gynecomastia in a Transgender Boy: A Case Report
Raymond Fung1, Mary Kathleen Greenaway2, Giancarlo McEvenue3
1Division of Endocrinology, Department of Medicine, Michael Garron Hospital, University of Toronto, Toronto, Canada.
AACE Clinical Case Reports
|November 12, 2021
Summary
Pubertal gynecomastia, previously undescribed in transgender boys, can occur during testosterone therapy after gonadotropin-releasing hormone (GnRH) agonist use. Adjusting testosterone dosage may reduce breast development.
Area of Science:
- Endocrinology
- Pediatric Endocrinology
- Gender-affirming care
Background:
- Gonadotropin-releasing hormone (GnRH) agonists are used for puberty suppression in transgender youth.
- Testosterone therapy is subsequently used for puberty induction and masculinization.
- Gynecomastia is common in cisgender males during puberty.
Observation:
- A 17-year-old transgender boy developed pubertal gynecomastia while on testosterone therapy.
- This occurred after prior treatment with a GnRH agonist since age 11.
- Gynecomastia resolved with a reduced testosterone dose.
Findings:
- This is the first reported case of pubertal gynecomastia in a transgender boy undergoing GnRH agonist and testosterone therapy.
- The development of gynecomastia may be linked to the hormonal transition process.
- Testosterone dose adjustment can effectively manage gynecomastia.
Implications:
- Highlights a potential side effect of combined GnRH agonist and testosterone therapy in transgender boys.
- Suggests careful monitoring and potential dose adjustments of testosterone are necessary.
- Informs clinical practice for managing pubertal development in transgender youth.
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