使用雌激素的生理男性平均寿命只有40岁是谣言吗（针对持续打激素的情况，半路退休的不算）？ 第1页

是谣言，这些东西已经很多人重复过了，现在已经9012年了。

Abstract
Objective: Adverse effects of long-term cross-sex hormone administration to transsexuals are not well documented. We assessed mortality rates in transsexual subjects receiving long-term cross-sex hormones.
Design: A cohort study with a median follow-up of 18.5 years at a university gender clinic. Methods: Mortality data and the standardized mortality rate were compared with the general population in 966 male-to-female (MtF) and 365 female-to-male (FtM) transsexuals, who started cross-sex hormones before July 1, 1997. Follow-up was at least 1 year. MtF transsexuals received treatment with different high-dose estrogen regimens and cyproterone acetate 100 mg/day. FtM transsexuals received parenteral/oral testosterone esters or testosterone gel. After surgical sex reassignment, hormonal treatment was continued with lower doses.
Results: In the MtF group, total mortality was 51% higher than in the general population, mainly from increased mortality rates due to suicide, acquired immunodeficiency syndrome, cardiovascular disease, drug abuse, and unknown cause. No increase was observed in total cancer mortality, but lung and hematological cancer mortality rates were elevated. Current, but not past ethinyl estradiol use was associated with an independent threefold increased risk of cardiovascular death. In FtM transsexuals, total mortality and cause-specific mortality were not significantly different from those of the general population.
Conclusions: The increased mortality in hormone-treated MtF transsexuals was mainly due to nonhormone-related causes, but ethinyl estradiol may increase the risk of cardiovascular death. In the FtM transsexuals, use of testosterone in doses used for hypogonadal men seemed safe.

In total, 1331 subjects met the above inclusion criteria, 966 (72.6%) MtF transsexuals, with a mean age of 31.4 years at the start of cross-sex hormones (range: 16–76 years), with 18 678 patient-years of follow-up, and 365 (27.4%) FtM transsexuals, with a mean age 26.1 years (range: 16–57 years) at the start of hormone therapy with 6866 patient-years of follow-up. Subjects were followed-up until July 1, 2007, or until the date of death. In 2009, we could cross check our database against the National Civil Record Registry (Gemeentelijke Basis Administratie) which registers all residents in the Netherlands and, if deceased, their date of death (but not cause of death). We identified another 45 MtF and 3 FtM subjects included in our database who had died before July 1, 2007, but were unknown to us in our initial analysis on mortality based on hospital records(19). Of these additional deaths, the cause of death could be ascertained in two out of three FtM (66%), and in 27 out of 45 (60%) MtF transsexual subjects. The mean follow-up period of subjects receiving cross-sex hormones was 19.3±7.7 years (median 18.6, range 0.7–44.5 years) in the MtF group. In the FtM group, the follow-up was 18.8±6.3 years (median 18.4, range 4.7–42.6 years;Table 1).

Results
Baseline characteristics
Baseline data and duration of follow-up in the patient groups are shown in Table 1. MtF transsexual subjects were older when they started cross-sex hormones (31.4±11.4 years) than FtM (26.1±7.4 years; P<0.001). In the MtF group, 207 subjects (21.4%) were over 40 years of age, and nine subjects (0.9%) were even over 65 years of age, whereas only few FtM (n=16, 4.4%) were over 40 years of age at the start of cross-sex hormone treatment. The mean duration of follow-up was not significantly different between MtF and FtM subjects (19.4±7.7 vs 18.8±6.3 years; P=0.12). The rate of sex reassignment surgery (defined as orchiectomy/penectomy+vaginoplasty in MtF and extirpation of the internal genitalia with both ovaries in FtM) was significantly lower in MtF compared to FtM subjects (86.7 vs 94.0%, P<0.001).
Mortality rates in MtF transsexuals
In the MtF group, 122 (12.6%) out of 966 subjects had died during follow-up. When compared with the adjusted expected mortality in the general population, MtF had a significantly increased mortality with a SMR of 1.51 (95% CI: 1.47–1.55; Table 2). The increased mortality in MtF in the 25–39 years of age group (SMR 4.47; 95% CI: 4.04–4.92) was mainly due to the relatively high numbers of suicides (in six), drugs-related death (in four), and death due to AIDS (in 13 subjects).In 40–64 year age group, the SMR of total mortality was increased with 1.42 (95% CI: 1.35–1.48). The higher rate as compared with the general population was largely explained by eight suicides (where only one was expected on the basis of mortality data in the general population) and 17 deaths from cardiovascular diseases (where only eight were expected). In the relatively small MtF group over 65 years of age, total mortality was not increased (SMR 0.95, 95% CI: 0.86–1.06) as compared to the general population.

重要的事情再重复一次：

Conclusions: The increased mortality in hormone-treated MtF transsexuals was mainly due to nonhormone-related causes.

• Asscheman, H., Giltay, E. J., Megens, J. A. J., de Ronde, W., van Trotsenburg, M. A. A., & Gooren, L. J. G. (2011). A long-term follow-up study of mortality in transsexuals receiving treatment with cross-sex hormones. European Journal of Endocrinology, 164(4), 635–642. doi:10.1530/EJE-10–1038