The researchers said prospective studies are needed to examine the effects of HT on bone microstructure, the effects of treatment on BMD independent of body composition, and whether the differences observed in the study are due to changes among cisgender adults, transgender adults or both. “We hypothesize that this may be due to low bone density prior to starting feminizing HT - which may be related to various potential factors, such as reduced exercise participation, less physical activity, greater social isolation or low vitamin D levels - or insufficient estradiol levels.” “Bone density in trans women was lower than control men,” Cheung said. Trabecular separation was 0.56 SD greater in transgender women compared with cisgender men ( P =. 01), and transgender women had 0.57 SD fewer trabeculae ( P <. Trabecular bone volume/tissue volume was 0.77 SD lower in transgender women than cisgender men ( P <. 01) in transgender women compared with cisgender men. 04) and cortical porosity 0.7 SD higher ( P <. 01), cortical thickness was 0.51 SD lower ( P =. Cortical volumetric BMD was 0.7 SD lower ( P <. 05) and 0.68 SD lower volumetric BMD ( P =. Transgender women had 0.21 SD lower total cross-sectional area ( P =. 05) in transgender men compared with cisgender women. 01) and trabeculae 0.38 SD thicker ( P =. Transgender men had 0.85 SD higher total cross-sectional area and 0.63 SD higher total volumetric BMD compared with cisgender women ( P =. The study included 41 transgender men compared with 71 cisgender women, and 40 transgender women compared with 51 cisgender men.
“We hypothesized that in transgender men, testosterone administration is associated with deficits in bone microarchitecture while in transgender women, estradiol administration is associated with preservation of bone microarchitecture.” “We therefore sought to determine whether measurement of microarchitecture will identify any association between gender-affirming hormone therapy and bone morphology,” the researchers wrote. Bone microarchitecture differences were presented in the number of standard deviations (SD) of the mean in cases for transgender participants relative to age-matched cisgender controls. All participants underwent imaging of the nondominant distal radius and distal tibia.
Data from transgender men receiving intramuscular or transdermal testosterone were compared with data from a control group of cisgender women, and data from transgender women receiving oral or transdermal estradiol were compared with those from cisgender men. Participants were recruited from endocrinology and primary care clinics specializing in transgender health in Melbourne. “Bone structure in transgender people using masculinizing hormones is not compromised.” Source: Adobe StockĬheung and colleagues conducted a cross-sectional study of transgender adults aged 18 years and older receiving gender-affirming HT for at least 1 year from April 2017 to April 2018. Cheung, MBBS (Hon), FRACP, PhD, associate professor in the departments of medicine and endocrinology at the University of Melbourne, Australia, told Healio. “Bone structure may potentially be impaired in transgender people using feminizing hormones, and whilst further study is needed to work out whether this is attributed to HT, a proactive approach to optimizing bone healthshould be recommended to all transgender people starting feminizing hormones,” Ada S. Transgender men receiving testosterone have higher total volumetric bone mineral density than cisgender women, whereas transgender women on estradiol have lower volumetric BMD compared with cisgender men, according to study data. BMD higher for transgender men, lower for transgender women vs cisgender controls
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