Publications by authors named "C J Kelley"

Context: Guidelines for use of injectable estradiol esters (valerate [EV] and cypionate [EC]) among transgender and gender diverse (TGD) individuals designated male at birth vary considerably, with many providers noting supraphysiologic serum estradiol concentrations based on current dosing recommendations.

Objectives: 1. Determine dose of injectable estradiol (subcutaneous [SC] and intramuscular [IM]) needed to reach guideline-recommended estradiol concentrations for TGD adults using EC/EV.

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Legg-Calvé-Perthes Disease (LCPD) is a condition marked by temporary blood flow disruption to the proximal femur, commonly afflicting children aged 15 and younger. The etiology of the disease is often idiopathic and involves the development of avascular necrosis of the femoral head, subsequently leading to bone weakening and deformity. Obesity exacerbates LCPD, correlating with delayed diagnosis, increased disease severity, and bilateral involvement.

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Injectable estrogens are options for gender-affirming hormone therapy per guidelines, which suggest intramuscular dosages of 5-30 mg every 2 weeks or 2-10 mg weekly with estradiol cypionate or valerate interchangeably. Data among transgender and gender-diverse patients are limited due to local unavailability and concerns around laboratory assay variability and estradiol (E2) level fluctuation. We note a concerning trend where patients are prescribed high-dose injections based on the guidelines leading to serum E2 levels well above the range recommended in the same guidelines.

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Transfeminine individuals are capable of developing breast tissue that is indistinguishable from cis-females, allowing them to breastfeed effectively. Breastfeeding affords known health benefits for both members of a lactating individual-infant dyad and supporting this experience for transfeminine individuals fosters reproductive equity. This study assessed experiences, attitudes, and knowledge regarding breastfeeding and lactation among a group of transfeminine individuals receiving hormone therapy within a specialized gender care clinic.

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