Hormones, Health, and Identity: Understanding Kidney Risks for Transgender People

Transgender and gender-diverse individuals often face hurdles in healthcare. One key area of concern is how hormone therapy affects kidney health. This treatment, known as gender-affirming hormone therapy (GAHT), helps people align their bodies with their gender identity. It involves different hormones for different groups. For instance, estrogen is used for transgender women, while testosterone is used for transgender men. For nonbinary individuals, the approach varies. Hormone therapy can change certain markers in the blood. These markers, like creatinine and cystatin C, help doctors check kidney function. The problem is, current methods for estimating kidney function might not work well for transgender people. This could lead to wrong diagnoses or misunderstandings about kidney disease. The effects of hormones on kidneys are not fully clear. Testosterone, for example, might raise creatinine levels. Estrogen, on the other hand, could lower them or have no effect. This makes it tricky to assess kidney health accurately. Additionally, hormones might influence the progression of chronic kidney disease and the risk of sudden kidney injury. Estrogen might protect the kidneys, while testosterone could increase risks. However, more research is needed to understand these effects better. Kidney transplants for transgender individuals come with their own set of challenges. Doctors need to consider how hormones affect the transplanted kidney and the patient's overall health. They also need to watch for interactions between hormones and medications. Plus, there are unique anatomical factors to consider. One big issue is the lack of data. Most health databases do not include enough information about transgender people. This makes it hard to study the long-term effects of hormone therapy on kidney health. Experts are calling for more comprehensive research. They want to better understand how to estimate kidney function in transgender individuals and how hormone therapy affects their kidney health in the long run.