Hormones, Health, and Identity: Understanding Kidney Risks for Transgender People
Transgender and gender-diverse individuals often face significant challenges in healthcare. One critical area of concern is the impact of hormone therapy on kidney health.
Gender-Affirming Hormone Therapy (GAHT)
Gender-affirming hormone therapy (GAHT) helps individuals align their bodies with their gender identity. Different hormones are used for different groups:
- Transgender women: Estrogen
- Transgender men: Testosterone
- Nonbinary individuals: Varies
Kidney Function and Hormone Therapy
Hormone therapy can alter blood markers like creatinine and cystatin C, which are used to assess kidney function. Current methods for estimating kidney function may not be accurate for transgender individuals, potentially leading to misdiagnoses or misunderstandings about kidney disease.
Effects of Hormones on Kidneys
The impact of hormones on kidney health is not fully understood:
- Testosterone: May increase creatinine levels.
- Estrogen: Could lower creatinine levels or have no effect.
These changes make it difficult to accurately assess kidney health. Additionally, hormones may influence the progression of chronic kidney disease and the risk of acute kidney injury:
- Estrogen: May protect the kidneys.
- Testosterone: Could increase risks.
More research is needed to fully understand these effects.
Kidney Transplants and Hormone Therapy
Kidney transplants for transgender individuals present unique challenges:
- Hormone effects: Doctors must consider how hormones affect the transplanted kidney and overall health.
- Medication interactions: Potential interactions between hormones and medications must be monitored.
- Anatomical factors: Unique anatomical considerations must be taken into account.
Lack of Data and Call for Research
A major issue is the lack of data on transgender individuals in health databases. This makes it difficult to study the long-term effects of hormone therapy on kidney health. Experts are calling for more comprehensive research to better understand:
- How to accurately estimate kidney function in transgender individuals.
- The long-term effects of hormone therapy on kidney health.