Bone health in transgender people: a narrative review

Bone health in transmen and transwomen is an important issue that needs to be evaluated by clinicians. Prior to gender-affirming hormone treatment (GAHT), transwomen have lower bone mineral density (BMD) and a higher prevalence of osteopenia than cismen probably related to external factors, such as...

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Bibliographic Details
Published in:Therapeutic Advances in Endocrinology and Metabolism 2022, Vol.13, p.20420188221099346-20420188221099346
Main Authors: Giacomelli, Giulia, Meriggiola, Maria Cristina
Format: Article
Language:English
Subjects:
Bone loss
Bone mineral density
Fractures
Gender
Gender aspects
Gender identity
Gender-Affirming Endocrine Care and Health Outcomes in Transgender and Gender Diverse Individuals
Gonadectomy
Gonadotropin-releasing hormone
Gonadotropins
Longitudinal studies
Osteopenia
Osteoporosis
Pituitary (anterior)
Population studies
Risk analysis
Risk factors
Transgender persons
Vitamin deficiency
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Summary:Bone health in transmen and transwomen is an important issue that needs to be evaluated by clinicians. Prior to gender-affirming hormone treatment (GAHT), transwomen have lower bone mineral density (BMD) and a higher prevalence of osteopenia than cismen probably related to external factors, such as hypovitaminosis D and less physical activities. Gonadotropin-releasing hormone (GnRH) analogues in transgender youth may cause bone loss; however, the addition of GAHT restores or at least improves BMD in both transboys and transgirls. The maintenance or increase in BMD shown in short-term longitudinal studies emphasizes that GAHT does not have a negative effect on BMD in adult transwomen and transmen. Gonadectomy is not a risk factor if GAHT is taken correctly. The prevalence of fractures in the transgender population seems to be the same as in the general population but more studies are required on this aspect. To evaluate the risk of osteoporosis, it is mandatory to define the most appropriate reference group not only taking into consideration the medical aspects but also in respect of the selected gender identity of each person.
ISSN:2042-0188
2042-0196
DOI:10.1177/20420188221099346