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24 C H A P T E R 2 RESULTS Description of study population A total of 207 individuals were approached for participation in this study. After obtaining informed consent, surveys were sent out to 114 participants of whom 92 completed their survey. Of these people, three initiated medical treatment above the age of 21 years and were therefore excluded. As a result, 89 participants were eligible for inclusion in the study cohort, which then consisted of 23 trans feminine and 66 trans masculine people. Characteristics of the total study cohort, and for trans feminine and masculine people separately, are shown in Table 1. Participants had a mean age of 32.4 years (SD 6.6, range 25.5-51.2) at time of the study, and 15.6 years (SD 2.2, range 11.5-20.6) at time of start of medical treatment. Of the total cohort, 82% received GnRHa prior to commencing GAHT. Educational level was relatively high (38% finished higher education), and more than 75% of the study population reported and income level above the poverty line. The majority of both trans masculine people and trans feminine people reported a heterosexual sexual orientation, but less than half of the study population reported to be in a relationship at time of the study. Only trans masculine people reported to have children, including biological, step-, foster, and adopted children. Table 1. Baseline characteristics of study cohort Total (n=89) Trans feminine (n=23) Trans masculine (n=66) Age at time of study 32.4 (SD 6.6, range 25.5-51.2) 31.9 (SD 5.5, range 25.6-44.5) 32.5 (SD 6.9, range 25.5-51.2) Age at time of start medical treatment 15.6 (SD 2.2, range 11.5-20.6) 15.5 (SD 1.9, range 12.9-19.6) 15.7 (SD 2.3, range 11.5-20.6) Used GnRHa prior to gender-affirming hormones - % (n) 82% (73) 87% (20) 80% (53) Educational level Elementary education Primary vocational education (LBO) Pre-vocational secondary education (VMBO/MAVO) Secondary vocational education (MBO) General secondary/pre-university education (HAVO/ VWO) Higher professional education (HBO) University education (WO) 2% (2) 1% (1) 14% (12) 39% (35) 6% (5) 21% (19) 17% (15) 0% 4% (1) 13% (3) 39% (9) 9% (2) 26% (6) 9% (2) 3% (2) 0% 14% (9) 39% (26) 5% (3) 20% (13) 20% (13) Level of income~ Below poverty line On poverty line Above poverty line 4% (4) 18% (16) 78% (69) 0% 22% (5) 78% (18) 6% (4) 17% (11) 77% (51) Civil status Single In a relationship 60% (53) 40% (36) 65% (15) 35% (8) 58% (38) 42% (28)

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