A person holding up their phone to view the TRANSform enrolment page.

Ongoing Research

 
Banner advertising the longitudinal gender study called TRANSform.
 

TRANSform

TRANSform is an ongoing survey designed to investigate the health and wellbeing experiences of the Australian trans, gender diverse and non-binary (TGDN) community. This includes all individuals aged 16 years and above who have a gender that is different from what was presumed for them at birth, including (but not limited to) trans, gender diverse and non-binary gender identities, or have a cultural gender identity different to man or woman.  It is a community-based participatory study and we are incredibly grateful to the nearly 2000 participants across Australia who have joined to-date since the project launch in May 2020. We are recruiting continuously and invite you to join us!

Participants will first complete an enrolment survey, which includes demographic information and your email address. Occasionally you will be invited by email to participate in a survey that is relevant to you (for example, people using testosterone for gender affirmation may be asked to participate in a survey about testosterone use). All surveys are optional and voluntary – if you do not want to participate you ignore the email. You can also opt out of TRANSform at any time.

The surveys will change each year depending on the priority health and wellbeing  issues affecting the community and participant feedback. Every survey is designed by researchers who are part of the TGDN community and further discussed with a Community Advisory Board, to ensure that it is relevant and contributes to our overall goal. Findings and recommendations from TRANSform will guide health service providers, researchers, and policy makers to optimise the health and wellbeing of the TGDN community. All participants will go into a draw to win one of 50 x $100 Giftpay vouchers that can be redeemed at a variety of stores and services.

 

Aims

The purpose of TRANSform is to provide robust, accurate, relevant and current information which will improve the health and well-being of the Australian TGDN community over time.

TRANSform aims to help shape the future of trans health and well-being in Australia by:

  • Providing voice to Australian trans individuals to have a say about their health, wellbeing and delivery of health services.

  • Understanding health needs of trans people across the lifespan to guide future policy and planning of gender-affirming and general health care services.

  • Identifying the social, psychological, physical, and environmental factors which determine good health, and those which cause ill-health, in trans people across the lifespan.

  • Providing information on the long-term health outcomes of trans people and factors which may modify this.

  • Raising the profile of community-led research and providing opportunity for trans researchers.

  • Providing a national research resource on trans health.

Themes

In 2020, TRANSform surveys examined:

  • The impact of the COVID-19 pandemic on the TGDN community, with results published in the International Journal of Transgender Health, and featured by a number of media outlets (e.g. ABC News),

  • Estradiol dose and well-being study. This study was open to ALL people using feminising hormone therapy and explored well-being in people with different types, doses and formulations of feminising hormone therapy such as estrogen, progesterone and anti-androgens and,

  • Pain experiences in people using testosterone therapy. This study was open to ALL trans people using masculinising hormone therapy.

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In 2021, TRANSform will examine:

  • The ongoing impact of the COVID-19 on the TGDN community including living situation, employment, disruptions to healthcare and support seeking,

  • Gender identity formation, affirmation, and experiences of gender euphoria study. This study aims to counter negative and damaging media coverage that has focused on ‘regret’, ‘detransition’ and ‘rapid onset dysphoria’, by shifting the narrative to a more positive one, and,

  • Suicide prevention strategies study. This study invites people who have experienced thoughts of suicide or have attempted suicide in the past 12 months, to express interest in taking part in an interview to explore how trans people express their suicide risk and what they want from those close to them in response to suicide communications to help to reduce suicide risk.

Investigators

This research has been initiated by the Trans Health Research Group, based at The University of Melbourne and a team of collaborators. Investigators include a core team of trans researchers; Sav Zwickl, Alex Wong, Kalen Eshin, Daria Chetcuti and Teddy Cook together with endocrinologists Dr Ada Cheung and Dr Lachlan Angus. We welcome collaborations.

Collaborations

We invite collaborating researchers who may seek to analyse existing data or to perform a new sub-study/survey as part of TRANSform to express interest via the Collaborate button. Expression of interest forms will be initially submitted to Sav Zwickl then reviewed by the investigative team to assess scientific validity and appropriateness of data use. All projects must directly contribute to improving the health or well-being of the community or contribute to the education or training of a trans researcher. Investigators will provide written feedback and subsequent ethical approval will need to be obtained.

 

New surveys are typically launched mid-year. Surveys will be finalised by December the previous year to enable appropriate review and ethics application prior to launch.

 
 
A doctor holding out pills and explaining them to a patient.
 

What is Involved?

This investigation is a blinded trial, which means participants receive a capsule of one of the anti-androgen drugs, but nobody knows what drug is in the capsule until the end of the study. Estradiol and Testosterone levels, as well as breast size and body fat distribution, will be measured over 6 months.

Participants

We are recruiting trans people that are newly starting estradiol, for this anti-androgen randomised controlled trial.

Aims

Our goal is to work out which anti-androgen drug (spironolactone 100mg daily or cyproterone 12.5mg daily) is better at breast growth and feminisation.

Benefits for Participants

  • Free anti-androgen drugs for 6 months.

  • Monitoring by endocrinologist every month until their estradiol levels are on target.

  • 3D photos to monitor their breast growth over 6 months.

  • Feminine and masculine fat distribution measurements (android/gynoid fat) over 6 months.

 

Testosterone Trial

 
A non-binary person injecting testosterone
 

Image credit: Gender Spectrum Collection.

 

What is Involved?

Participants will see an endocrinologist for initial assessment and will be randomised (randomly allocated) to rapid access to testosterone therapy, compared with standard care (starting testosterone typically within 3 months of initial assessment). This will allow us to measure dysphoria, mental health, and quality of life over 3 months. We can compare trans people in one group on testosterone, and one group not yet on testosterone.

Participants

We are recruiting trans people seeking full-dose testosterone therapy, for gender affirmation, who are yet to start.

Aims

Our goal is to demonstrate the benefit of testosterone, on dysphoria and quality of life, in order to support getting testosterone on the PBS for gender affirmation.

Benefits for Participants

  • Participants can potentially access very rapid care and commencement of testosterone therapy, if suitable.

  • Even those randomised to standard care will have an assessment, and start testosterone sooner than most current wait lists in Melbourne.

 

GAME Study

 
A man in a wheelchair lifting weights
 

What is Involved?

This world-first study will follow people over the first 12 months of gender affirming hormones to monitor muscle strength, fitness and power  (based at the specialised elite sports facility at Victoria University in Footscray). Monitoring includes exercise testing, blood and muscle sample collections, and body composition scans over 1 year. It is estimated that participants will have to attend 6-9 sessions.

Participants

We are recruiting trans people who are about to commence full-dose gender affirming hormones (testosterone OR estradiol) from beginning (before starting) to 12 months. We are also recruiting people (trans and cis) who are not on any hormones as a comparison group.

Aims

Our goal is to understand the impact of HRT on muscle strength and fitness, to inform sporting policy guidelines internationally.

Benefits for Participants

Free fitness tests and body composition.