Pubertal Blockade and Estradiol Effects on Cardiometabolic Health for Transitioning Youth

Pubertal Blockade and Estradiol Effects on Cardiometabolic Health for Transitioning Youth

To evaluate the effect of estradiol with or without a prior gonadotropin releasing hormone analogue on insulin sensitivity and vascular function in transgender females compared to cisgender controls.

Inclusion Criteria (transgender females):

• Identify as a transgender female
• Age 13-16 years at the time of enrollment
• If on a gonadotropin releasing hormone analogue, > 6 months exposure
• Plan to start estradiol clinically in < 4 months

Inclusion Criteria (cisgender males and females):

• Males and females ages 13-16 years

Exclusion Criteria:

• Cognitive, psychiatric, or physical impairment resulting in inability to tolerate the study procedures
• Antipsychotic medication use
• Type 1 or 2 diabetes (by medical history)
• Polycystic ovarian syndrome (PCOS for cisgender females)
• Hypertension (resting BP ≥ 140/90 mm/Hg)
• Weight> 400 lbs
• On oral progesterone medications (including oral progesterone or progestin, combined oral contraceptives or etonogestrel implant)
• Pregnancy (for cisgender females)