Efficacy of Fixed Low-Dose Weekly Subcutaneous Testosterone Self-Administration in Transgender Male Patients in India

Introduction: Testosterone (T) is commonly administered intramuscularly to treat hypogonadal males and female-to-male (FTM) transgender patients. Intramuscular testosterone administration has various drawbacks, including discomfort, bruising, pain, and the need to be administered by a healthcare professional. Self-administered subcutaneous route may be a convenient, safe, and effective alternative. The current study assesses the efficacy and safety of low-dose (50 mg) weekly subcutaneous testosterone administration among FTM transgender. Methods: The current retrospective cohort study included adult FTM transgender subjects. Participants were administered T-cypionate weekly at a dose of 50 mg and followed up for 6 months. At the end of the follow-up, serum concentrations of testosterone, oestradiol (E2), and the number of participants achieving target E2 (<50 pg/mL) and testosterone (300–700 ng/mL) levels were determined. Results: The patient cohort consisted of 22 FTM transgender subjects. The average age was 29 years and body mass index was 26.3 ± 3.3 kg/m 2 . After 6 months of follow-up, a significant rise in testosterone to 511.3 ± 204.3 ng/mL ( P < 0.0001) and a significant decrease in E2 levels to 46.6 ± 16.2 ( P < 0.0001) were noted in study subjects compared to baseline. Target testosterone and E2 levels were achieved (>300 ng/mL) in 81% and 68% of subjects, respectively. Ninety-one per cent of subjects had cessation of menstruation. No subject needed to stop testosterone injections or decrease dosage due to polycythaemia (PCV > 50%). Conclusion: Weekly self-administered 50 mg low-dose, subcutaneous testosterone injection was effective in achieving target testosterone and oestradiol levels in FTM transgender subjects, without significant safety issues.