In this study, we evaluated the effects of genistein and sex hormone supplementation on the modification of transcription factor PPARs (α, δ and γ) and their contribution to the NASH pathogenesis by using a testosterone-deficient rat model fed with an HFHF diet in an attempt to mimic the condition of NASH in transwomen. This evidence concerns the gene PLXNA3 and metabolic dysfunction-associated steatohepatitis.