Role of clinical laboratories in reporting results of transgender individuals on hormonal therapy

Transgender individuals experience discordance between their gender identity and sex assigned at birth. To relieve the disconnection between their identity and their biological state, some may take hormonal therapy, which leads to notable changes in several laboratory results. As reference intervals in the clinical laboratory reports are mainly gender specific for biological male and female, the transgender population on hormonal therapy may end up with misinterpretation of their test results, which could lead to misdiagnosis or inappropriate medical decisions. The aim of this review is to highlight the challenges experienced by clinicians in this regard and some strategies used to interpret these results. Establishing reference intervals for transgender individuals will assist in correct interpretation of patients’ results and their management. This will also maximise their overall health, psychological well-being and self-actualisation.