Gender-affirming hormone therapy in transgender women and risk of prostate cancer: pathophysiological mechanisms and clinical implications

Gender-affirming hormone therapy (GAHT) for transgender women (TGW) transition is typically based on a combination of estrogens and androgen deprivation therapy. This treatment is designed to recalibrate the hormonal balance in TGW. GAHT promotes the development of female secondary sexual characteristics; in addition, it has a significant impact on mood, cognitive status, and behavior [2]. The biological and potentially pathological adaptations that male genitalia—particularly the prostate—undergo during the TGW transition remain unclear and source of several questions.