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REVIEW article

Front. Dent. Med
Sec. Periodontics
Volume 5 - 2024 | doi: 10.3389/fdmed.2024.1430193
This article is part of the Research Topic Sex and Aging in Periodontal Diseases View all articles

Unveiling sex-disparities and the impact of gender-affirming hormone therapy on periodontal health

Provisionally accepted
Cristina C. Villar Cristina C. Villar 1*Mariane C. Sloniak Mariane C. Sloniak 1Josiane Assis Josiane Assis 2Renata C. Porto Renata C. Porto 1Giuseppe A. Romito Giuseppe A. Romito 1
  • 1 Division of Periodontology, University of São Paulo, São Paulo, Brazil
  • 2 Institute of Biomedical Science, University of São Paulo, São Paulo, Brazil

The final, formatted version of the article will be published soon.

    As personalized medicine advances, the need to explore periodontal health across different sexes and gender identities becomes crucial. This narrative review addresses the gap in understanding how biological sex and gender-affirming hormone therapy (GAHT) influence periodontitis risk. Results: Research has uncovered significant sex-based immunological disparities driven by X and Y chromosome gene expression and sex-hormones, which may influence susceptibility to periodontitis. Additionally, preliminary findings suggest that GAHT, particularly testosterone therapy in transgender men, could exacerbate pro-inflammatory cytokine production and alter immune cell responses, which may exacerbate inflammatory pathways crucial in the progression of periodontitis. Conversely, the effects of estrogen therapy in transgender women, although less extensively studied, suggest modifications in B cell functionality. These observations highlight the complex role of GAHT in modulating immune responses that are central to the development and exacerbation of periodontal disease. Discussion: The review highlights a complex interaction between sex hormones, gene expression patterns, immune responses, and periodontitis risk. While cisgender males show increased susceptibility to periodontitis that could be linked to specific immune pathways, GAHT appears to modify these pathways in transgender individuals, potentially altering their risk and disease progression patterns. Conclusion: There is a critical need for more focused research on the direct impacts of GAHT on periodontal health. Understanding the nuances of immune modulation by GAHT will aid in crafting personalized periodontal care for transgender individuals, aligning with the broader goals of inclusive and effective healthcare.

    Keywords: Periodontitis, Immunity, Gonadal Steroid Hormones, Biological sex, gender-affirming care

    Received: 09 May 2024; Accepted: 29 Aug 2024.

    Copyright: © 2024 Villar, Sloniak, Assis, Porto and Romito. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Cristina C. Villar, Division of Periodontology, University of São Paulo, São Paulo, Brazil

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.