(O-21) MAJOR ADVERSE EFFECTS OF ANABOLIC STEROID USE IN TRANSGENDER MEN DURING GENDER-REAFFIRMING HORMONE THERAPY: A SYSTEMATIC REVIEW OF THE LITERATURE

Gender-affirming hormone therapy for female-to-male transsexuals is based on testosterone administration. Testosterone therapy (TT) is associated with side effects such as arteriosclerosis and insulin resistance, among others. This review aims to synthesize the main findings in the literature regarding these adverse effects and identify gaps in knowledge that will guide future studies A systematic review of the literature was carried out with search strategies based on Mesh terms. The bibliographic databases PubMed, Embase, and SCOPUS were selected, and the following search algorithm was applied. We included clinical trials, meta-analyses, systematic reviews, and cohort studies. The articles were evaluated by three investigators, who initially reviewed the title and abstract and determined whether the article met the inclusion criteria. We followed the recommendations of the PRISMA statement for this process. The search provided a total of 93 articles (PubMed n = 61, Embase n = 2, Scopus n = 30). Four duplicates were eliminated. Finally, 22 articles met the inclusion criteria. Two studies found hematologic side effects of TT; 4 studies evidenced an increase of metabolic profile without any clinically significant side effects, 1 cohort showed an incidence of hepatic failure of 0.6% in the first year. 2 studies showed that TT was associated with endothelial disfunction and a proinflammatory state. 1 study showed an increase in body weight and lean mass and reduction in body fat. 3 studies showed that TT has no association with an increased risk of breast cancer. 1 study reported a high prevalence of acne with a highest value at 6 months post initiation of therapy. The use of TT showed side effects on metabolic profile bases without clinically significant repercussions. Additionally, even after showing endothelial damage, no cardiovascular events were reported. Further studies are required about this topic. Figure 1. Flowchart Selection of items according to PRISMA 2020. No conflict.