A Nonspecific Disturbance of the Gonadostat in Women with Transsexualism and Isolated Hypergonadotropism in the Male-to-Female Disturbance of Gender Identity

Summary

Principal parameters of gonadostat function were determined in 15 female-to-male (F-M) and 7 male-to-female (M-F) transsexual patients (T), all homosexuals. The data were compared with normal heterosexual controls of the respective sex.

Anamnesis revealed prolongation of the menstrual cycles in F-M patients, mainly in those taking previously medication with depot-testosterone. However, also in patients with no previous medication the basal body temperature chart revealed anovulatory cycles (all 4 examined patients). In 8 of 9 patients (82.2%) with no previous medication an elevation of serum testosterone was found (63—600 ng/dl).

No disturbances in gonadal functions were found in M-F group (semen analysis), serum testosterone was normal (328—710 ng/dl) except 1 case with reduced testosterone level (200 ng/ml).

Both women and men with transsexualism revealed significantly higher mean basal serum concentration of LH in comparisons to controls (F-M: 23.14 ±16.16 vs 7.56 ± 4.23; M-F 15.30 ± 6.49 vs 5.75 ±3.66). No changes in basal serum FSH concentration were present. GnRH test (100 μg i.v.) revealed decreased evocability of LH in woman with T and exaggerated LH response in men with T. FSH hyperresponse to GnRH was nonsignificant in F-M and significant in M-F T.

It is concluded that F-M transsexualism is associated with nonspecific disturbances of gonadostat since hypergonadotropism coexists with the signs of impaired gonadal function. In M-F T and isolated hypergonadotropism coexisted with specific, increased sensitivity of the pituitary to GnRH.

Key words

Transsexualism - Gonadal Functions - Gonadotropins