SIGIS-SIAMS-SIE position statement of gender affirming hormonal treatment in transgender and non-binary people

PURPOSE

Gender Incongruence (GI) is a marked and persistent incongruence between an individual's experienced and the assigned gender at birth. In the recent years, there has been a considerable evolution and change in attitude as regards to gender nonconforming people.

METHODS

According to the Italian Society of Gender, Identity and Health (SIGIS), the Italian Society of Andrology and Sexual Medicine (SIAMS) and the Italian Society of Endocrinology (SIE) rules, a team of experts on the topic has been nominated by a SIGIS-SIAMS-SIE Guideline Board on the basis of their recognized clinical and research expertise in the field, and coordinated by a senior author, has prepared this Position statement. Later on, the present manuscript has been submitted to the Journal of Endocrinological Investigation for the normal process of international peer reviewing after a first internal revision process made by the SIGIS-SIAMS-SIE Guideline Board.

RESULTS

In the present document by the SIGIS-SIAMS-SIE group, we propose experts opinions concerning the psychological functioning, gender affirming hormonal treatment, safety concerns, emerging issues in transgender healthcare (sexual health, fertility issues, elderly trans people), and an Italian law overview aimed to improve gender non-conforming people care.

CONCLUSION

In this Position statement, we propose experts opinions concerning the psychological functioning of transgender people, the gender-affirming hormonal treatment (full/partial masculinization in assigned female at birth trans people, full/partial feminization and de-masculinization in assigned male at birth trans people), the emerging issues in transgender health care aimed to improve patient care. We have also included an overview of Italian law about gender affirming surgery and registry rectification.

In vitro effects of myo-inositol on normokinetic human semen samples with nonlinear motility

OBJECTIVE

As myo-inositol (MI) deficiency has been associated with impaired sperm quality, we aimed to assess its effects on sperm kinetics objectively, using a computer-aided sperm analysis (CASA) system.

PATIENTS AND METHODS

We evaluated 59 normokinetic semen samples with nonlinear progressive motility before and after incubation with a solution of MI. The samples were collected from healthy subjects aged 20-40 years who were attending our Laboratory of Seminology for fertility screening.

RESULTS

We found a significant increase in linear progressive motility (28.2% ± 10.8 vs. 30.9% ± 11.0, T0 vs. T1 respectively; p <0.001) and a significant reduction in nonlinear progressive motility (21.0% ± 9.9 vs. 18.1% ± 10.2, T0 vs. T1 respectively; p <0.001) after incubation with MI. CASA analysis revealed a significant increase in curvilinear velocity (VCL) (65.0 ± 19.0 vs. 67.9 ± 20.4 µm/s, T0 vs. T1 respectively; p = 0.049). Overall, there was an increase in VCL in 42/59 samples (about 70%), mainly from non-smokers.

CONCLUSIONS

These results suggest that MI has a positive in vitro effect on semen samples, but confirmation is needed through further studies taking into account factors capable of modulating MI response, such as smoking and obesity.

Effects of a dietary supplement on cholesterol in subjects with moderate hypercholesterolemia

BACKGROUND AND AIMS

Prospective studies have demonstrated that the risk of death due to ischaemic heart disease is strongly correlated with blood cholesterol (TC) levels. Diet is the basic treatment for all dyslipidaemia. If diet alone proves inadequate, supplements can be used to try to reduce cholesterol levels. These substances are indicated in moderate dyslipidaemia, as they are able to induce a moderate reduction in blood cholesterol. The objective of our study was to investigate the effects of a dietary supplement containing Omega-3, Policosanol, Resveratrol, L-carnitine, Monascus purpureus, Coenzyme Q10, Vitamin B6 and Vitamin B12 on TC (primary end point) and LDL, triglycerides and HDL (secondary endpoints).

PATIENTS AND METHODS

The study involved 40 men and 40 women recruited from the outpatient section of our Department randomly assigned to the treatment group (A) or the control group (B).

RESULTS

There was a statistically significant reduction in TC 6 months after the end of treatment in both groups. In Group A, there was also a statistically significant change in HDL, LDL and TG, while in group B, there was no statistically significant change in HDL, LDL or TG.

CONCLUSIONS

The dietary supplement used in our study, in combination with a balanced diet and physical exercise, was found to induce a significant reduction in TC and LDL-C and an improvement in HDL-C. In contrast, while a balanced diet together with physical exercise but without the dietary supplement produced a significant reduction in TC, it had no significant effect on the other lipid parameters tested.