Meningiomas in three male-to-female transgender subjects using oestrogens/progestogens

What is it about?

We found three patients who developed a meningioma in male-to-female transgenders in addition to five other who have been described in the literature. Considering that the occurrence of meningiomas is twice as high in women than in men, the prevalence of meningiomas in males in the normal population would be 32.5/ 100 000. By contrast, extrapolating from our cohort this would amount to 126/100 000 prevalence of meningiomas in male-to-female transgenders. Continuous high-dose cross-sex hormone administration to male-to-female transgender persons, therefore, seems to increase the risk of developing a meningioma. These findings support the role of female sex hormones in the development and growth of meningiomas. This might be an underrepresentation, because there is no standard protocol for screening for meningiomas in this population and meningiomas can remain asymptomatic for several years.

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Why is it important?

These findings strongly suggest that there is a relationship between sex hormones and the development and growth of some meningiomas and that this relationship is not restricted to women. The occurrence of meningiomas in male-to-female transgenders is, fortunately, rare but there might be an underreporting. Cases should receive an individualised follow-up