https://www.sciencedirect.com/science/a ... 3825001062

Clinicopathologic analysis and digital pathology evaluation of orchiectomy specimens in gender-affirmation surgery

Abstract
Gender-affirmation therapies for transgender and gender diverse (TGD) individuals has been increasing in numbers in recent years. TGD patients usually undergo various forms of hormonal replacement therapy (HRT) followed by bilateral orchiectomy. We aimed to characterize the histological and biochemical alterations in these specimens. From 2018–2023, 63 TGD individuals undergone gender-affirming orchiectomy. Atrophic changes, decreased spermatogenesis, and reduced mean tubule diameter with basement membrane thickening, as well as maturation arrest and aspermatogenesis were identified. A subset of specimens (n = 81, 64.8 %) showed germ cell nucleomegaly with cytological atypia mimicking germ cell neoplasia in situ, and detailed digital pathology and immunohistochemical were performed to distinguish this finding from true neoplastic processes. To our knowledge, this is the largest single-center cohort of gender-affirming orchiectomy specimens.

Nothing surprising…? One would easily expect changes in cells in testicles if you use hormone therapy for a prolonged period.

Not specifically interesting, except there was the question they were trying to answer about the possibility of 'dangerous' changes in the testicles as a result of the chemical castration, i.e. cancer, or at least that is what I got from trying to follow the medicalese...

Unfortunately the limited availability of the article context makes it hard to tell exactly what they found in terms of this possible concern....

It would also theoretically be limited by the fact that all the patients were at one center, and presumably only had a limited subset of medications that they were given... For instance Androcur is not FDA approved, so it is used a lot in the rest of the world, but not in the US... So the results would cover changes in response to the drugs that were used, but the ones that were not used might not have the same results....

(And it also ignores the question of those that used various DIY injectables like alcohol or CaCl, etc...)

I do wish we had members with the sort of institutional access that could get us able to view these papers but I don't think this is one that is significant enough to put a lot of effort into digging up.

WheelyFixed