Evidence map›Paper›PMID 39777707›Full record

SynthesisHormones (Athens, Greece)2025

Patient-reported outcomes, provider-reported outcomes, and physiologic parameters after gender-affirming hormone treatment in Canada: a systematic review.

Liam Jackman, Cynthia Chan, Micon Garvilles, Rakhshan Kamran

Abstract readSystematic Review
In one paragraph

Synthesis in Hormones (Athens, Greece), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Liam JackmanInstitute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.
Cynthia ChanDepartment of Family and Community Medicine, University of Toronto, Toronto, ON, Canada.
Micon GarvillesNuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, OX37LD, UK.
Rakhshan KamranNuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, OX37LD, UK. rakhshan.kamran@hertford.ox.ac.uk.ORCID http://orcid.org/0000-0003-4298-4848

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeCanada has experienced a ten-fold increase in referrals for gender-affirming care. Clinical guidelines emphasize the importance of a comprehensive and systematic approach to outcome measurement for gender-affirming hormonal care. However, research is lacking on the investigation of outcomes of Canadian gender-affirming hormonal treatments.

methodsIn total, five databases were searched, as follows: MEDLINE, Embase, PsycINFO, Scopus, and CINAHL on December 26, 2023. To meet inclusion criteria, each study needed to be an original article including patients identifying as transgender or gender diverse (TGD) who were receiving gender-affirming hormonal care in Canada. The Critical Appraisal Skills Programme (CASP) and Joanna Briggs Institute (JBI) tools were used to assess the methodological quality of the study. Descriptive frequencies were calculated for demographic information and a narrative synthesis was conducted to summarize outcomes organized for different treatments.

resultsA total of 3315 articles were identified, with 34 articles being included, representing 3990 patients. Physiologic parameters were reported in 62% of the studies and patient-reported outcomes (PROs) in 50%, although only 32% utilized standardized patient-reported outcome measures (PROMs). In studies reporting quantitative results, testosterone treatments showed 80% effectiveness in achieving desired physical changes, while several studies demonstrated that estrogen and antiandrogen treatments improved mental health in 85% of patients. The narrative synthesis of the results reveals positive outcomes and limited adverse effects of gender-affirming hormone therapy; however, it also underscores the need for standardized, consistent outcome measurement tools, particularly PROMs.

conclusionThe present systematic review highlights the need for standardized outcome reporting in gender-affirming hormone therapy, underscoring the need for measurement of the patient's perspective through PROMs. Resolving these issues can improve evidence-based practices and support high-quality, patient-centered gender-affirming hormone care.

Indexed as

Gender-Affirming ProceduresHormone Replacement TherapyPatient Reported Outcome MeasuresTransgender PersonsCanadaFemaleHumansMaleGender-affirming careHealth services for transgender personsHealth services researchHormone therapyPatient-reported outcome measuresPhysiologic parametersPROMsProvider-reported outcomesSystematic review

Identifiers

PMID39777707
PMCPMC12339595

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.