Chronotype changes after sex hormone use 205 whom 23% a form containing only progestogens and 21% a combined oral contraceptive with estradiol and progestogens. At baseline, TF participants had a median age of 27 ± 5 years and 43% had school or work on more than 3 days per week. The most common form of estradiol prescribed at the start of GAHT was oral estradiol (61%), the second most common form were estradiol patches (30%) and 9% used estradiol gel. The majority of TF participants started using a form of GnRHanalogues as testosterone suppressant (84%) at the start of GAHT, and three TF participants started using cyproterone acetate (9%). Table 7.1. Characteristics of the transmasculine (TM) and transfeminine (TF) groups reported per measurement time point. TM participants TF participants Measurement point Baseline (n=48) 3 months (n=38) Baseline (n=44) 3 months (n=37) Age (years; median, interquartile range) 22 (19.8; 24) 22 (19.5; 24) 26 (24; 31) 27 (24.8; 32.3) Alcohol use Units per week (median, interquartile range ) Missing 0 (0; 1) 1 0.5 (0; 0.5) 13 0.5 (0 to 2) 2 0.5 (0 to 2) 12 Smoking (n, %) Current smoker Not current smoker Missing 5 (10%) 42 (88%) 1 (2%) 3 (8%) 25 (66%) 10 (26%) 6 (14%) 38 (67%) 0 (0%) 1 (3%) 31 (84%) 5 (13%) Use of alarm clock on free days (n, %) 17 (35%) 14 (35%) 15 (34%) 12 (32%) Work or school days per week (n, %) Less than 3 days of school or work 3 or more days of school or work 18 (37%) 11 (29%) 19 (43%) 19 (51%) 30 (63%) 27 (71%) 25 (57%) 18 (48%) Serum hormone levels (median, interquartile range) a. Testosterone (nmol/L) 0.9 (0.6; 1.2) 19 (13.5; 24.5) 13 (10; 17.5) 0.55 (0.4; 0.8) Estradiol (pmol/L) 114 (79; 208) 134 (104; 186) 71.5 (59.8; 89.5) 283 (180; 396.3) a. Reference values for cisgender men: testosterone, 9 to 30 nmol/L, estradiol, 12 pmol/L to 126 pmol/L. Reference values for premenopausal cisgender women: testosterone, 0.3 to 1.6 nmol/L, estradiol, 31 pmol/L to 2864 pmol/L. (Amsterdam UMC Endocrinologisch Lab et al., z.d.; Verdonk et al., 2019). 3.2. Transmasculine group As displayed in Table 7.2 and in Figure 7.2, the TM group shows a 20-minute later MSFsc after 3 months of masculinizing GAHT in the unadjusted model, a
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