Facial feminization and masculinization The effects of cross-sex hormone treatment on facial features in individuals with gender dysphoria

Tebbens, M. (Marieke) (2016) Facial feminization and masculinization The effects of cross-sex hormone treatment on facial features in individuals with gender dysphoria. thesis, Medicine.

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Abstract

Background. The face is an important factor in the recognition of gender. Therefore, facial feminization or masculinization is particularly important for individuals with gender dysphoria, both in self-image and social interaction. Although cross-sex hormonal treatment is used for several decades, little is known about its effects on the face. Therefore, our study aim is to provide more insight into these effects, using 3D imaging. Design. We performed a single center cohort study in which we studied 20 patients with gender dysphoria (14 Male-to-Females (MtFs) and 6 Female-to-Males (FtMs), median age 28.3, IQR 21.5-30.0 years), who were treated with a regimen of cross-sex hormones according to protocol (testosterone in FtMs and estrogen combined with cyproterone acetate in MtFs). 3D facial images were made with an Artec Spider scanner at baseline and after 3 months of treatment. The primary outcome was the deviation of skin in millimeters after 3 months of treatment, measured in 22 soft tissue landmarks. Results. Face surface mappings (color maps) in MtFs demonstrated a small shift of skin in the jaw and cheek region. The jaw landmarks shifted to medial (right mean= 0.66mm; 95% CI 0.19-1.01, left mean 0.70mm; 95%CI, 0.37-1.03) and the cheek landmark shifted to anterior (mean=0.43mm; 95%CI, 0.05 to 0.79). In FtMs, face surface mappings showed a small posterior shift of skin in the cheek region (mean=-0.45mm; 95%CI, 0.22-0.83). Conclusions. In both MtFs and FtMs, the face shows changes even in the first 3 months of treatment. These changes are in the direction of desired facial sex characteristics. Our study demonstrates that cross-sex hormonal treatment induces facial feminization in MtFs and masculinization in FtMs. Further research is needed to provide more insight into long-term effects and the association with gender recognition and self-esteem.

Item Type:	Thesis (Thesis)
Supervisor name:	Faculty supervisor: and Pouwels, Dr. M.J.M. and Institution: Medisch Spectrum Twente, Enschede Department: I
Supervisor name:	Daily supervisor: and Heijer, Prof. Dr. M. den and Institution: VU University Medical Center, Amsterdam and Department: Internal medicine, endocrinology
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 11:02
Last Modified:	25 Jun 2020 11:02
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/2248

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