Pharmacological Therapy in Patients With Gender Dysphoria: A Cohort Study in the Lazio Region, Italy

Individuals with gender dysphoria (GD) experience discomfort or distress related to gender incongruence. Management often requires pharmacological support for hormonal and psychological needs. This study aimed to identify a cohort of GD patients in the Lazio Region and analyze their medication use compared with the general population.

Using regional health information systems, we identified individuals with incident hospitalizations for GD between 2011 and 2021. We assessed medication use in the year following discharge and compared it with an age- and sex-matched population sample (1:10 ratio). We calculated the proportion of individuals with at least one dispensed prescription in selected therapeutic classes, with 95% confidence intervals.

We identified 365 individuals with GD (median age 26 years), of whom 52.9% were assigned male at birth (AMAB) and 47.1% were assigned female at birth (AFAB). Within one year, 72.1% (67.5%-76.7%) of GD individuals received at least one medication, compared to 43.1% (41.5%-44.7%) in the general population. Medicine use was higher among AMAB (83.9%) than AFAB (58.7%). The most prescribed drug classes were anti-infectives (35%), sex hormones (35%), gastrointestinal/metabolic agents (28%), and nervous system drugs (18%). Patterns differed by sex assigned at birth: estrogens, anti-androgens, and vitamins were common in AMAB, while acid-related disorder drugs, psychotropics, and testosterone were more frequent in AFAB.

GD patients showed higher medication use than the general population, with distinct patterns by sex assigned at birth. These findings highlight the importance of monitoring and evaluating long-term safety of pharmacological therapies.