Table 6. Demographics based on type of gender-affirming hormone therapy: Estrogen versus testosteronea.
| Estrogen (N = 1326) |
Testosterone (N = 1070) |
All (N = 2396) |
p-valueb | |
|---|---|---|---|---|
| Age at first hormone prescription | <0.001 c | |||
| 18–20 | 235 (17.7%) | 311 (29.1%) | 546 (22.8%) | |
| 21–30 | 670 (50.6%) | 576 (53.8%) | 1246 (52.0%) | |
| 31–40 | 231 (17.4%) | 137 (12.8%) | 368 (15.4%) | |
| 41–64 | 169 (12.8%) | 44 (4.1%) | 213 (8.9%) | |
| 65+ | 21 (1.6%) | 2 (0.2%) | 23 (1.0%) | |
| Age at first hormone prescription- Mean (SD) | 29.3 (11.0) | 25.3 (7.35) | 27.5 (9.78) | <0.001 |
| Therapy start year | 0.034 | |||
| 2005–2016 | 115 (8.7%) | 134 (12.5%) | 249 (10.4%) | |
| 2017–2018 | 176 (13.3%) | 132 (12.3%) | 308 (12.9%) | |
| 2019 | 171 (12.9%) | 131 (12.2%) | 302 (12.6%) | |
| 2020 | 210 (15.8%) | 167 (15.6%) | 377 (15.7%) | |
| 2021 | 315 (23.8%) | 220 (20.6%) | 535 (22.3%) | |
| 2022–2023 | 339 (25.6%) | 286 (26.7%) | 625 (26.1%) | |
| Therapy start year–Mean (SD) | 2020 (2.58) | 2020 (2.57) | 2020 (2.57) | 0.222 |
| Race | 0.004 | |||
| White | 1153 (89.3%) | 902 (85.6%) | 2055 (85.8%) | |
| Black or African American | 11 (0.9%) | 25 (2.4%) | 36 (1.5%) | |
| Asian | 25 (1.9%) | 22 (2.1%) | 47 (2.0%) | |
| American Indian/ Alaska Native | 19 (1.5%) | 11 (1.0%) | 30 (1.3%) | |
| Native Hawaiian/Pacific Islander | 12 (0.9%) | 7 (0.7%) | 19 (0.8%) | |
| Other | 71 (5.5%) | 87 (8.3%) | 158 (6.6%) | |
| Unknown race | 35 (-) | 16 (-) | 51 (2.1%) | |
| Ethnicity | <0.001 | |||
| Hispanic/Latino | 91 (7.2%) | 142 (13.7%) | 233 (9.7%) | |
| Not Hispanic/Latino | 1172 (92.8%) | 891 (86.3%) | 2063 (86.1%) | |
| Unknown ethnicity | 63 (-) | 37 (-) | 100 (4.2%) | |
| Body Mass Index categoryd | <0.001 | |||
| Underweight (<18.5) | 53 (5.1%) | 40 (4.5%) | 93 (3.9%) | |
| Normal (18.5–24.99) | 439 (42.5%) | 293 (33.3%) | 732 (30.6%) | |
| Overweight (25.0–29.99) | 275 (26.6%) | 218 (24.8%) | 493 (20.6%) | |
| Obese (> = 30) | 266 (25.8%) | 329 (37.4%) | 595 (24.8%) | |
| Unknown BMI | 293 (-) | 190 (-) | 483 (20.2%) | |
| Body Mass Index—Mean (SD)d | 26.8 (7.01) | 29.0 (8.31) | 27.8 (7.72) | <0.001 |
| Body Mass Index—Mean (SD)e | 26.7 (6.91) | 28.7 (8.08) | 27.6 (7.54) | <0.001 |
| Married/Life partner | 250 (20.4%) | 230 (23.0%) | 480 (20.0%) | |
| Divorced/Legally separated | 86 (7.0%) | 33 (3.3%) | 119 (5.0%) | |
| Widowed | 10 (0.8%) | 0 (0%) | 10 (0.4%) | |
| Single | 878 (71.7%) | 736 (73.7%) | 1614 (67.4%) | |
| Unknown/Other | 102 (-) | 71 (-) | 173 (7.2%) | |
| Sex (EHRf reported) | <0.001 c | |||
| Female | 392 (29.7%) | 770 (72.0%) | 1162 (48.5%) | |
| Male | 922 (69.9%) | 290 (27.1%) | 1212 (50.6%) | |
| Nonbinary | 5 (0.4%) | 10 (0.9%) | 15 (0.6%) | |
| Unknown sex | 7 (-) | 0 (-) | 7 (0.3%) | |
| Gender identity | <0.001 § | |||
| Female | 335 (25.3%) | 10 (0.9%) | 345 (14.4%) | |
| Male | 17 (1.3%) | 203 (19.0%) | 220 (9.2%) | |
| Transgender Female | 722 (54.4%) | 3 (0.3%) | 725 (30.3%) | |
| Transgender Male | 5 (0.4%) | 534 (49.9%) | 539 (22.5%) | |
| Non-binary | 93 (7.0%) | 161 (15.0%) | 254 (10.6%) | |
| Unknown gender identity | 154 (11.6%) | 159 (14.9%) | 313 (13.1%) | |
| Insurance status | 0.002 | |||
| Commercial | 1010 (76.2%) | 870 (81.3%) | 1880 (78.5%) | |
| Medicaid | 168 (12.7%) | 113 (10.6%) | 281 (11.7%) | |
| Medicare | 62 (4.7%) | 25 (2.3%) | 87 (3.6%) | |
| Misc Government | 39 (2.9%) | 22 (2.1%) | 61 (2.5%) | |
| Unknown insurance | 47 (3.5%) | 40 (3.7%) | 87 (3.6%) | |
| State | 0.379 | |||
| Idaho | 27 (2.0%) | 15 (1.4%) | 42 (1.8%) | |
| Nevada | 12 (0.9%) | 11 (1.0%) | 23 (1.0%) | |
| Utah | 1247 (94.0%) | 998 (93.3%) | 2245 (93.7%) | |
| Wyoming | 15 (1.1%) | 17 (1.6%) | 32 (1.3%) | |
| Other statesg | 25 (1.9%) | 29 (2.7%) | 54 (2.3%) | |
| Gender-affirming surgery | <0.001 | |||
| No | 1090 (82.2%) | 685 (64.0%) | 1775 (74.1%) | |
| Yes | 236 (17.8%) | 385 (36.0%) | 621 (25.9%) | |
| Gender-Affirming surgery type | <0.001 | |||
| Top | 45 (3.4%) | 314 (29.3%) | 359 (15.0%) | |
| Bottom | 134 (10.1%) | 31 (2.9%) | 165 (6.9%) | |
| Both | 57 (4.3%) | 40 (3.7%) | 97 (4.0%) | |
| No surgery | 1090 (82.2%) | 685 (64.0%) | 1775 (74.1%) | |
| Rurality | 0.089 | |||
| Urban | 1253 (94.5%) | 992 (92.7%) | 2245 (93.7%) | |
| Rural | 73 (5.5%) | 78 (7.3%) | 151 (6.3%) | |
aIndividuals had at least two unique prescriptions for hormone therapy.
bMissing values were not included when calculating the p-values (chi-square test is used to compare categories, t-test is used to compare means).
cFisher’s exact test used.
dMean BMI before and closest to index date.
eMean BMI of all BMI’s prior to index date.
fEHR = Electronic Health Record.
gOther state include: AZ, CA, CO, CT, HI, IL, KY, MD, MO, MS, MT, NM, NY, OH, OK, OR, PA, SC, SD, TN, TX, WA.