Impact of gender-affirming hormone therapy on the development of COVID-19 infections and associated complications: A systematic review

Table 3 Transgender care and coronavirus disease 2019

Ref.	Study type	Findings
Masterson et al[38]	Prospective Case study	TW patients treated with E+P as part of feminizing GAHT showed reduced testicular ACE-2 R expression in testicular tissue. In comparison to control group (cis-gender males with no hormone therapy) and the TW cohort treated with E only, O+E cohort also had higher degree of tissue fibrosis. Significance: Support the possibility that short course of E+P or P alone could help protect men against COVID-19 infection through downregulation of ACE-2 Receptor
Durcan et al[39]	Single center, cross-sectional web-based survey	Of 238 participants (179 FTM, 59 FTM) with GD receiving hormone therapy, the risk of contracting COVID-19 was 3.46x higher in FTM receiving testosterone therapy, compared with FTM patients receiving estrogen and anti-androgen therapies. Furthermore, among the FTM cohort, longer treatment periods with testosterone was associated with increased risk of contracting COVID-19; Significance: TM receiving Testosterone as part of GAHT are at an increased risk for contracting COVID-19