I'm transgender and want my results interpreted against the right reference ranges for me

I'm transgender and would like my results interpreted against the right reference ranges for me - what do I do?

Currently, our laboratories default to providing reference ranges according to your sex assigned at birth because they do not know the stage of your transition or whether you take gender-affirming hormone therapy. We are working on this process to make it as helpful and medically accurate as possible.

What can I do in the meantime?

When you take a test, you will have the option to add additional details in the supporting information box. 

You can input your gender as M>F or F>M and provide extra details about your transition in this section. Please add this information for each test you take, as not all biomarkers are affected in the same way as you transition (research is divided on this). You do not have to share medication details with us, but it can help the doctor to review your results. 

If appropriate, the doctor will provide comments and advice on your hormone results using a representative reference range for the gender you are transitioning to. 

Your results:

• If you provide extra information about your transition, your written report on your hormone markers will reflect your affirmed gender. However, your lab results and reference ranges will be displayed according to your birth sex. 
• Generally, after six months of hormone therapy, your results will fall into the normal range of your affirmed gender. 
• Between zero and six months, there is a grey area where some sex-specific biomarkers and hormones may fall between male and female ranges. 
• Your biological sex can influence a few non-hormone markers, such as your full blood count, liver, and kidney function. Unfortunately, the evidence base on how to interpret these values in transgender patients receiving gender-affirming hormone treatment is limited. Some current guidance (e.g. from NHS Lothian Laboratories March 2020) advises using ranges for the assigned sex at birth for these markers. 

What if I’m non-binary? 

We recognise that gender is a spectrum, and some people identify as neither male nor female - or somewhere in between.  

Generally, we advise interpreting your results against your sex assigned at birth for the most accurate reflection of your health.  

Some of your results may fall between male and female reference ranges if you take lower-dose masculinising or feminising hormone therapy. In these cases, let our doctors know in your supporting information.

Research in this area is limited, and interpretation is often on an individual basis.  

Inclusivity is important to us 

In the future, we would like this process to be more streamlined, and we have already made good leaps forward, working with some of our trans customers. Please be assured we are committed to getting it right and giving you whatever support you need on your journey.

If you have any questions, please contact our customer care team.