Transgender Women’s Risk Of Metabolic Disease Altered By Sex Reassignment Surgery

When transgender women undergo sex reassignment surgery rather than hormone therapy alone, the risk that the transgender woman will face metabolic disease changes. New research presented at the conference called Cardiovascular, Renal and Metabolic Diseases: Physiology and Gender from the American Physiological Society indicates that sex reassignment surgery actually protects transgender women from metabolic disease. It’s not just the hormone therapy protecting the transgender women from metabolic disease, either. The actual sex reassignment surgery offers more protection from metabolic disease than hormone therapy alone.

The research into sex reassignment surgery and its link to risk of metabolic disease was led by Dr. Michael Nelson of the Cedars-Sinai Medical Center in Los Angeles. Dr. Nelson and his research team developed a study to assess metabolic risk of transgender women transitioning from male to female, because some earlier research showed that transgender women who transition with only hormone therapy, but without sex reassignment surgery, might have greater risk for certain diseases like type 2 diabetes and high blood pressure.

For the small study, the researchers studied 12 transgender women. Four of the women were taking hormone therapy, and eight of them were taking hormone therapy and underwent sex reassignment surgery by having bilateral orchiectomy. Bilateral orchiectomy is a sex reassignment surgery in which both testicles are removed. For their research, they measured insulin resistance and the buildup of fat in the liver. Insulin resistance is a key indicator of poor metabolic health, according to Medical News Today, while the buildup of fat in the liver can cause nonalcoholic fatty liver disease and increase the risk of heart disease.

The women who received both the female hormone therapy and the sex reassignment surgery had better metabolic health than transgender women who were only given female hormone therapy, the researchers found. Transgender women with the highest levels of the predominantly male hormone, testosterone, has the poorest metabolic health compared to the other study participants. Transgender women who were not given sex reassignment surgery also had greater accumulations of fat in the liver than the women who had not undergone the sex reassignment surgery. The researchers believe that transgender women who have sex reassignment surgery instead of just hormone therapy are likely protected against insulin resistance and fatty liver disease. When transgender women only receive hormone medications, they are more likely to suffer metabolic disease.

Rebecca Kling, a transgender artist and educator, shared what life was like before her reassignment surgery, the process of the surgery, and how life has changed for her, and the account was featured in Women’s Health.

“Trans identity is often presented as this foreign and impossible-to-understand idea. At the end of the day, we all want to feel comfortable in our skin and respected in our identity. That’s not a trans trait, that’s a human trait.”

Kling hopes that surgery will be more readily covered by insurance, and now, it appears that research indicates that there could be crucial metabolic advantages to surgery rather than just taking hormones alone.

Recently, researchers also discovered that on the opposite front, transgender males are at greater risk of cervical cancer when they are given testosterone therapy without complete sex reassignment surgery.

The new research indicates that both transgender females and transgender males might enjoy better health and lower risk of disease while taking hormone therapy if they are also given sex reassignment surgery.

[Image via Pixabay]