Observational study characterizes ovarian histopathology in transgender patients on testosterone

This observational cohort study examined ovarian histopathology characteristics in transgender and gender-diverse individuals who underwent gender-affirming hysterectomies at a single academic institution in Wisconsin between January 1, 2016, and December 31, 2023. The study focused on patients using testosterone, though no comparator group was reported, and the sample size was not specified. The primary outcome was characterization of ovarian histopathology, but specific findings, effect sizes, absolute numbers, and statistical measures were not reported in the available data.

Safety and tolerability data, including adverse events, serious adverse events, and discontinuations, were not reported. The study had no reported follow-up period, limiting assessment of longer-term ovarian changes. The authors noted that limited data exists on the effects of exogenous testosterone on ovarian tissue, which represents a significant knowledge gap in gender-affirming care.

Key limitations include the observational design, which cannot establish causation between testosterone use and specific ovarian changes. The single-institution setting and unspecified sample size may limit generalizability. The study contributes to the growing gender-affirming care database that guides shared decision-making between providers and patients, but clinicians should interpret findings cautiously given the incomplete reporting of results and acknowledged data limitations.