A rare reaction to endocrine therapy

A patient’s pulse and respiratory rate increases dramatically after an injection. What happened?

James, a 27-year-old transgender man, presented eagerly for his first injection of testosterone as the endocrine component of his gender transition. 

James was not taking any regular medication and had no known allergies.

He was previously treated for depression with escitalopram and psychotherapy, but found that addressing his gender dysphoria had been more effective for his mood disorder.

Assessment with a psychiatrist confirmed James’ gender dysphoria and he was found to be a suitable candidate for endocrine therapy.