The differences between female hormones and male hormones may not be as specific as you might think. The definition of a hormone is a chemical substance produced by an endocrine gland that has a specific effect on the activities of other organs in the body. The major female and male hormones can be classified as estrogens or androgens. Both classes of male and female hormones are present in both males and females alike, but in vastly different amounts. Most men produce 6-8 mg of the male hormone testosterone (an androgen) per day, compared to most women who produce mg daily. Female hormones, estrogens, are also present in both sexes, but in larger amounts for women.
Alkaline phosphatase, hemoglobin and hematocrit, and creatinine may vary depending on the patient's current sex hormone configuration. Several factors contribute to these differences, bone mass, muscle mass, number of myocytes, presence or lack of menstruation, and erythropoetic effect of testosterone. Many transgender men do not menstruate, and those with male-range testosterone levels will experience an erythropoetic effect. As such an amenorrheic transgender man taking testosterone, registered as female and with hemoglobin/hematocrit in the range between the male and female lower limits of normal, may be considered to have anemia, even though the lab report may not indicate so. Conversely, the lack of menstruation, and presence of exogenous testosterone make it reasonable to use the male-range upper limit of normal for hemoglobin/hematocrit. Using the male-range upper limit of normal for alkaline phosphatase and creatinine may also be appropriate for transgender men due to increased bone and muscle mass, respectively. In these cases the provider should reference the male normal ranges for their lab.