Comparison of Estrone/Estradiol Ratio and Levels in Transfeminine Individuals on Different Routes of Estradiol
Bibliographic record
Abstract
Purpose: Estradiol for gender-affirming hormone therapy can be taken in different routes: oral, sublingual, transdermal patch or gel, and injectable estradiol. We aimed at comparing the estrone and estradiol ratios and levels achieved in each of these different routes of estradiol. Methods: We conducted a retrospective chart review of transfeminine individuals attending an endocrinology clinic in Toronto, Canada. Study participants were grouped according to the route of estradiol administration: oral, injectable, transdermal, and sublingual. Our primary outcome was the estrone/estradiol ratio (E1/E2). Our secondary outcomes were the estradiol and estrone levels in each of these four groups. Results: We included 286 patients. The oral estradiol group had the highest E1/E2 ratio (9.28), followed by the sublingual group (6.88). Both the transdermal and injectable groups had substantially lower E1/E2 ratios (2.22 and 0.84, respectively). We observed a large variability of the E1/E2 ratio in the oral and sublingual groups, whereas the transdermal and the injectable groups' ratios had much smaller standard deviation. The mean estradiol in the injectable group (1557 pmol/L, 424.1 pg/mL) was markedly higher than the estradiol levels observed in all other routes of estradiol. Conclusion: Our data demonstrate significantly different E1/E2 ratios in the four different routes of estradiol administration, with oral and sublingual routes having the highest E1/E2 ratios followed by transdermal and injectable routes.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".