Cross-sex hormonal treatment in transgender persons does not decrease areal bone density; a 2 year follow-up study

* Both first authors have contributed equally to this paperGiven the importance of adequate sex steroid exposure for skeletal health, bone metabolism should be a focus of interest in transgender persons. Previous studies... [ view full abstract ]

* Both first authors have contributed equally to this paper

Given the importance of adequate sex steroid exposure for skeletal health, bone metabolism should be a focus of interest in transgender persons. Previous studies suggested higher prevalence of low bone mass in both trans men and trans women. However, prospective studies investigating bone metabolism during the first two years of cross-sex hormonal treatment are scarce.

To evaluate areal bone mineral density (aBMD) in transgender persons before initiation of cross-sex hormonal treatment and after one and two years. [ view full abstract ]

To evaluate areal bone mineral density (aBMD) in transgender persons before initiation of cross-sex hormonal treatment and after one and two years.

This study is part the endocrine part of the European Network for the Investigation of Gender Incongruence (ENIGI). Belgian data of 148 trans women and 84 trans men were analyzed. [ view full abstract ]

This study is part the endocrine part of the European Network for the Investigation of Gender Incongruence (ENIGI). Belgian data of 148 trans women and 84 trans men were analyzed.

Before administration of cross-sex hormones and after one and two years, aBMD was assessed by DXA scanning at the lumbar spine and proximal femur. [ view full abstract ]

Before administration of cross-sex hormones and after one and two years, aBMD was assessed by DXA scanning at the lumbar spine and proximal femur.

Trans women were older (32.6 years) than trans men (26.0 years). In trans women, aBMD had increased after one year (baseline: 0.97 ± 0.14 g/cm2, 0.94 ± 0.14 g/cm2 and 0.81 ± 0.13 g/cm2 at lumbar spine, total hip and... [ view full abstract ]

Trans women were older (32.6 years) than trans men (26.0 years). In trans women, aBMD had increased after one year (baseline: 0.97 ± 0.14 g/cm2, 0.94 ± 0.14 g/cm2 and 0.81 ± 0.13 g/cm2 at lumbar spine, total hip and femoral neck, respectively; compared to year 1: 1.02 ± 0.14 g/cm2 (P < 0.001), 0.95 ± 0.14 g/cm2 (P=0.002) and 0.82 ± 0.14 g/cm2(P<0.001)). No significant changes in aBMD were observed between year 1 and 2.
In trans men, aBMD had increased at the total hip after 1 year (0.94 ± 0.13 g/cm2 at baseline to 0.95 ± 0.13 g/cm2 (P=0.026) at year 1), remaining stable thereafter. At the lumbar spine, aBMD had increased after 2 years of treatment (1.02 ± 0.11 g/cm2 at baseline to 1.03 ± 0.11 g/cm2 at year 2 (P = 0.023). No significant changes in aBMD at the femoral neck were found.

We present for the first time prospective data on aBMD in a large group of transgender persons after two years of cross-sex hormonal therapy. Our results indicate that cross-sex hormones do not negatively affect bone mass in... [ view full abstract ]

We present for the first time prospective data on aBMD in a large group of transgender persons after two years of cross-sex hormonal therapy. Our results indicate that cross-sex hormones do not negatively affect bone mass in these patients. On the contrary, small increases in aBMD were observed in both trans men and trans women.