Characterization of a Distinct Rectal Mucosal Transcriptome among Transgender Women utilizing Cross-Sex Hormone Therapy

A comparison of rectal mucosal RNA transcriptome findings between transgender women using feminizing hormone therapy, men who have sex with men engaging in receptive anal intercourse, and males who had never engaged in anal intercourse demonstrates differential gene expression involving pathways critical for mucosal inflammation, suggesting the urgent need for further exploration into the immunologic effects of cross-sex hormone therapy in the rectal mucosa and the potential impact on HIV transmission risk at this site. Rectal mucosal biopsies were obtained from 9 transgender women using cross-sex hormone therapy and from these, total RNA was extracted for RNA-Seq analysis. The RM transcriptome of TGW was compared to stored specimens from a prior study that included 10 MSM engaging in CRAI and 10 men who reported no history of AI; the previously stored specimens were re-sequenced from extracted RNA to control for batch effect.