Preservation of volumetric bone density and geometry in trans women during cross-sex hormonal therapy: a prospective observational study
Abstract
Unlabelled Although trans women before the start of hormonal therapy have a less bone and muscle mass compared with control men, their bone mass and geometry are preserved during the first 2 years of hormonal therapy, despite of substantial muscle loss, illustrating the major role of estrogen in the male skeleton.Purpose The aim of this study is to examine the evolution of areal and volumetric bone density, geometry, and turnover in trans women undergoing sex steroid changes, during the first 2 years of hormonal therapy.Methods In a prospective observational study, we examined 49 trans women (male-to-female) before and after 1 and 2 years of cross-sex hormonal therapy (CSH) in comparison with 49 age-matched control men measuring grip strength (hand dynamometer), areal bone mineral density (aBMD), and total body fat and lean mass using dual X-ray absorptiometry (DXA), bone geometry and volumetric bone mineral density, regional fat, and muscle area at the forearm and calf using peripheral quantitative computed tomography. Standardized treatment regimens were used with oral estradiol valerate, 4 mg daily (or transdermal 17-β estradiol 100 μg/24 h for patients >45 years old), both combined with oral cyproterone acetate 50 mg daily.Results Prior to CSH, trans women had lower aBMD at all measured sites (all p < 0.001), smaller cortical bone size (all p < 0.05), and lower muscle mass and strength and lean body mass (all p < 0.05) compared with control men. During CSH, muscle mass and strength decreased and all measures of fat mass increased (all p < 0.001). The aBMD increased at the femoral neck, radius, lumbar spine, and total body; cortical and trabecular bone remained stable and bone turnover markers decreased (all p < 0.05).Conclusions Although trans women, before CSH, have a lower aBMD and cortical bone size compared with control men, their skeletal status is well preserved during CSH treatment, despite of substantial muscle loss.
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Three cross-sectional studies reported that transwomen had 6.4% and 8.0% lower lean body mass than cisgender men and reductions of 4% in lean body mass in transwomen with 12 months of GAHT.
“These studies reported 6.4% and 8.0% lower LBM than in cisgender men and reductions of 4% in LBM in the transwomen with 12 months of GAHT.”
In the same study, forearm cross-sectional area was decreased by 8.6% after 12 months, yet at 24 months was 4.4% lower than baseline, indicating that forearm cross-sectional area was 4.2% larger at 24 months than at 12 months.
“The same study reported that compared with baseline, forearm CSA was decreased by 8.6% after 12 months, yet at 24 months was 4.4% lower than baseline, indicating that forearm CSA was 4.2% larger at 24 months than at 12 months.”
A decrease in muscle cross-sectional area of 1.5%-11.7% was reported over periods ranging from 12 to 36 months in transwomen on GAHT.
“A decrease in CSA of 1.5%–11.7% was reported over periods ranging from 12 to 36 months.”
One study reported a 1.5% decrease in tibia cross-sectional area compared with baseline after 12 months and a 3.8% decrease after 24 months.
“The second study41 reported a 1.5% decrease in tibia CSA compared with baseline after 12 months and a 3.8% decrease compared with baseline after 24 months.”
One cross-sectional study reported 9% smaller cross-sectional area in hormone-naive transwomen than in cisgender men, with the transwomen undergoing a further 4% decrease in cross-sectional area with 24 months of GAHT.
“One study reported 9% smaller CSA in hormone-naive transwomen41 than in cisgender men, with the transwomen undergoing a further 4% decrease in CSA with 24 months of GAHT.”
The largest ENIGI study (n=249) and one other study found significant reductions in hand grip strength (4.3% and 7.1%, respectively) after 12 months on GAHT (p<0.001).
“The largest of the three (n=249) ENIGI studies17 and one other study41 found significant (p<0.001) reductions (4.3% and 7.1%, respectively) after 12 months on GAHT.”
Compared with cisgender men, hormone-naive transwomen demonstrate approximately 10%-14% lower handgrip strength.
“~10%–14% lower handgrip strength.17 41 60”
Compared with cisgender men, hormone-naive transwomen demonstrate 6.0%-11.4% lower muscle cross-sectional area.
“6.0%–11.4% lower muscle CSA”
One cross-sectional study found 14% lower hand grip strength in hormone-naive transwomen than in cisgender men (p<0.001) and a further 7% reduction in hand grip strength of the transwomen after 12 months of GAHT.
“One study found 14% lower hand grip strength in hormone-naive transwomen than in cisgender men (p<0.001)41 and a further 7% reduction in hand grip strength of the transwomen after 12 months of GAHT.”
Compared with cisgender men, hormone-naive transwomen demonstrate 6.4%-8.0% lower lean body mass.
“hormone-naive transwomen demonstrate 6.4%–8.0% lower LBM,41 51”
Twelve longitudinal studies have examined the effects of testosterone suppression on lean body mass or muscle size in transgender women.
“Including Gooren and Bunck [62], 12 longitudinal studies [53, 63–73] have examined the effects of testosterone suppression on lean body mass or muscle size in transgender women.”
From Transgender Women in the Female Category of Sport: Perspectives on Testosterone Suppression and Performance Advantage (2021) · cites this paper as [53]
Hand-grip strength in transgender women was reduced from baseline by 7% and 9% after 12 and 24 months, respectively, of cross-hormone treatment.
“van Caenegem et al. [53] reported that hand-grip strength was reduced from baseline measurements by − 7% and − 9% after 12 and 24 months, respectively, of cross-hormone treatment in transgender women.”
From Transgender Women in the Female Category of Sport: Perspectives on Testosterone Suppression and Performance Advantage (2021) · cites this paper as [53]
Cites
A short questionnaire for the measurement of habitual physical activity in epidemiological studies
Baecke, J. A. H., BUREMA, J., & Frijters, J. E. R. (1982) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/36.5.936 · Cited by 3,950 · see citing works
Coleman, E., Bockting, W. O., Botzer, M., Cohen‐Kettenis, P. T., Cuypere, G. D., Feldman, J., Fraser, L., Green, J., Knudson, G., Meyer, W. J., et al. (2012) · International Journal of Transgenderism · doi:10.1080/15532739.2011.700873 · Cited by 3,145 · see citing works
Bone “mass” and the “mechanostat”: A proposal
Frost, H. M. (1987) · The Anatomical Record · doi:10.1002/ar.1092190104 · Cited by 2,132 · see citing works
Smoking and fracture risk: a meta-analysis
Kanis, J. A., Johnell, O., Oden, A., Johansson, H., De Laet, C., Eisman, J. A., Fujiwara, S., Kroger, H., McCloskey, E. V., Mellstrom, D., et al. (2005) · Osteoporosis International · doi:10.1007/s00198-004-1640-3 · Cited by 999 · see citing works
Khosla, S., Oursler, M. J., & Monroe, D. G. (2012) · Trends in Endocrinology & Metabolism · doi:10.1016/j.tem.2012.03.008 · Cited by 943 · see citing works
Gonadal Steroids and Body Composition, Strength, and Sexual Function in Men
Finkelstein, J. S., Lee, H., Burnett-Bowie, S.-A. M., Pallais, J. C., Yu, E. W., Borges, L. F., Jones, B. F., Barry, C. V., Wulczyn, K. E., Thomas, B. J., et al. (2013) · New England Journal of Medicine · doi:10.1056/nejmoa1206168 · Cited by 782 · see citing works
Falahati-Nini, A., Riggs, B. L., Atkinson, E. J., O’Fallon, W. M., Eastell, R., & Khosla, S. (2000) · Journal of Clinical Investigation · doi:10.1172/jci10942 · Cited by 757 · see citing works
Effects of vitamin D supplements on bone mineral density: A systematic review and meta-analysis
Reid, I. R., Bolland, M. J., & Grey, A. (2014) · The Lancet · doi:10.1016/s0140-6736(13)61647-5 · Cited by 678 · see citing works
A long-term follow-up study of mortality in transsexuals receiving treatment with cross-sex hormones
Asscheman, H., Giltay, E. J., Megens, J. A. J., de Ronde, W., van Trotsenburg, M. A. A., & Gooren, L. J. (2011) · European Journal of Endocrinology · doi:10.1530/eje-10-1038 · Cited by 570 · see citing works
Estrogen Regulation of Growth Hormone Action
Leung, K., Johannsson, G., Leong, G. M., & Ho, K. K. Y. (2004) · Endocrine Reviews · doi:10.1210/er.2003-0035 · Cited by 544 · see citing works
Mortality and morbidity in transsexual subjects treated with cross‐sex hormones
van Kesteren, P. J. M., Asscheman, H., Megens, J. A. J., & Gooren, L. J. (1997) · Clinical Endocrinology · doi:10.1046/j.1365-2265.1997.2601068.x · Cited by 532 · see citing works
Hochberg, M. C., Greenspan, S. L., Wasnich, R. D., Miller, P. D., Thompson, D. E., & Ross, P. D. (2002) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.87.4.8415 · Cited by 480 · see citing works
Sexual Dimorphism in Skeletal Size, Density, and Strength
Seeman, E. (2001) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.86.10.7960 · Cited by 426 · see citing works
Physical Activity in Childhood May Be the Key to Optimizing Lifespan Skeletal Health
Gunter, K. B., Almstedt, H. C., & Janz, K. F. (2012) · Exercise and Sport Sciences Reviews · doi:10.1097/jes.0b013e318236e5ee · Cited by 270 · see citing works
Elbers, J. M. H., Asscheman, H., Seidell, J. C., & Gooren, L. J. G. (1999) · American Journal of Physiology-Endocrinology and Metabolism · doi:10.1152/ajpendo.1999.276.2.e317 · Cited by 236 · see citing works
Skeletal sexual dimorphism: relative contribution of sex steroids, GH–IGF1, and mechanical loading
Callewaert, F., Sinnesael, M., Gielen, E., Boonen, S., & Vanderschueren, D. (2010) · Journal of Endocrinology · doi:10.1677/joe-10-0209 · Cited by 224 · see citing works
Bone mineral density in patients with prostatic cancer treated with orchidectomy and with estrogens
Eriksson, S., Eriksson, A., Stege, R., & Carlstr�m, K. (1995) · Calcified Tissue International · doi:10.1007/bf00298427 · Cited by 191 · see citing works
Elbers, J. M. H., Asscheman, H., Seidell, J. C., Frölich, M., Meinders, A. E., & Gooren, L. J. (1997) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.82.10.4284 · Cited by 189 · see citing works
van Kesteren, P. J. M., Lips, P. T. A. M., Gooren, L. J., Asscheman, H., & Megens, J. A. J. (1998) · Clinical Endocrinology · doi:10.1046/j.1365-2265.1998.00396.x · Cited by 181 · see citing works
Toremifene to Reduce Fracture Risk in Men Receiving Androgen Deprivation Therapy for Prostate Cancer
Smith, M. R., Morton, R. A., Barnette, K. G., SIEBER, P. R., Malkowicz, S. B., Rodriguez, D., Hancock, M. L., & Steiner, M. S. (2012) · The Journal of Urology · doi:10.1016/j.juro.2012.11.016 · Cited by 160 · see citing works
Lorentzon, M., Swanson, C., Andersson, N., Mellström, D., & Ohlsson, C. (2005) · Journal of Bone and Mineral Research · doi:10.1359/jbmr.050404 · Cited by 159 · see citing works
Bone Loss After Bariatric Surgery: Discordant Results Between DXA and QCT Bone Density
Yu, E. W.-Y., Bouxsein, M., Roy, A. E., Baldwin, C. M., Cange, A., Neer, R. M., Kaplan, L. M., & Finkelstein, J. S. (2013) · Journal of Bone and Mineral Research · doi:10.1002/jbmr.2063 · Cited by 153 · see citing works
A European network for the investigation of gender incongruence: The ENIGI initiative
Kreukels, B. P. C., Haraldsen, I., Cuypere, G. D., Richter‐Appelt, H., Gijs, L. A. C. L., & Cohen‐Kettenis, P. T. (2010) · European Psychiatry · doi:10.1016/j.eurpsy.2010.04.009 · Cited by 146 · see citing works
Endocrine Treatment of Male-to-Female Transsexuals Using Gonadotropin-Releasing Hormone Agonist
Dittrich, R., Binder, H., Cupisti, S., Hoffmann, I., Beckmann, M., & Mueller, A. (2005) · Experimental and Clinical Endocrinology & Diabetes · doi:10.1055/s-2005-865900 · Cited by 141 · see citing works
Body composition, volumetric and areal bone parameters in male-to-female transsexual persons
Lapauw, B., Taes, Y., Simoens, S., Van Caenegem, E., Weyers, S., Goemaere, S., Toye, K., Kaufman, J.-M., & T'Sjoen, G. G. (2008) · Bone · doi:10.1016/j.bone.2008.09.001 · Cited by 131 · see citing works
Self-citationCaenegem, E. V., Taes, Y., Wierckx, K., Vandewalle, S., Toye, K. R. C., Kaufman, J., Schreiner, T., Haraldsen, I., & T'Sjoen, G. G. (2013) · Bone · doi:10.1016/j.bone.2013.01.039 · Cited by 130 · see citing works
Self-citationTowards a diagnostic and therapeutic consensus in male osteoporosis
Kanis, J. А., Bianchi, G., Bilezikian, J. P., Kaufman, J.-M., Khosla, S., ORWOLL, E. S., & Seeman, E. (2011) · Osteoporosis International · doi:10.1007/s00198-011-1632-z · Cited by 129 · see citing works
Self-citationFiers, T., Casetta, B., Bernaert, B., Vandersypt, E., Debock, M., & Kaufman, J. (2012) · Journal of Chromatography B · doi:10.1016/j.jchromb.2012.02.034 · Cited by 127 · see citing works
Self-citationCross-sex pattern of bone mineral density in early onset gender identity disorder
Haraldsen, I. R., Haug, E., Falch, J., Egeland, T., & Opjordsmoen, S. (2007) · Hormones and Behavior · doi:10.1016/j.yhbeh.2007.05.012 · Cited by 113 · see citing works
Ruetsche, A. G., Kneubuehl, R., Birkhaeuser, M. H., & Lippuner, K. (2004) · Osteoporosis International · doi:10.1007/s00198-004-1754-7 · Cited by 93 · see citing works
Mueller, A., Zollver, H., Kronawitter, D., Oppelt, P. G., Claassen, T., Hoffmann, I., Beckmann, M. W., & Dittrich, R. (2010) · Experimental and Clinical Endocrinology & Diabetes · doi:10.1055/s-0030-1255074 · Cited by 93 · cited 4× · see citing works
“Also, treatment regimens with or without anti-androgens were described which hampers clear comparisons (cyproterone acetate in [14, 18] or GnRHanalogues in [10, 12, 13]).”
BackgroundMethodResultInfluentialAssociation between bone turnover rate and bone microarchitecture in men: The STRAMBO study
Chaitou, A. R., Boutroy, S., Vilayphiou, N., Munoz, F., Delmas, P. D., Chapurlat, R. D., & Szulc, P. (2010) · Journal of Bone and Mineral Research · doi:10.1002/jbmr.124 · Cited by 80 · see citing works
The effect of cross-gender hormonal treatment on bone metabolism in male-to-female transsexuals
Lips, P. T. A. M., Asscheman, H., Uitewaal, P. J. M., Netelenbos, J. C., & Gooren, L. J. (1989) · Journal of Bone and Mineral Research · doi:10.1002/jbmr.5650040503 · Cited by 68 · see citing works
Nilsson, M., Ohlsson, C., Odén, A., Mellström, D., & Lorentzon, M. (2012) · Journal of Bone and Mineral Research · doi:10.1002/jbmr.1549 · Cited by 64 · see citing works
Lapauw, B., Taes, Y., Bogaert, V., Vanbillemont, G., Goemaere, S., Zmierczak, H., Bacquer, D. D., & Kaufman, J. (2008) · Journal of Bone and Mineral Research · doi:10.1359/jbmr.081260 · Cited by 62 · see citing works
Self-citationT'Sjoen, G., Weyers, S., Taes, Y., Lapauw, B., Toye, K., Goemaere, S., & Kaufman, J.-M. (2009) · Journal of Clinical Densitometry · doi:10.1016/j.jocd.2008.11.002 · Cited by 58 · see citing works
Self-citationMueller, A., Dittrich, R., Binder, H., Kuehnel, W., Maltaris, T., Hoffmann, I., & Beckmann, M. W. (2005) · European Journal of Endocrinology · doi:10.1530/eje.1.01943 · Cited by 58 · see citing works
The effects of oestrogen exposure on bone mass in male to female transsexuals
Reutrakul, S., Ongphiphadhanakul, B., Piaseu, N., Krittiyawong, S., Chanprasertyothin, S., Bunnag, P., & Rajatanavin, R. (1998) · Clinical Endocrinology · doi:10.1046/j.1365-2265.1998.00614.x · Cited by 57 · see citing works
Svensson, J., Movérare‐Skrtic, S., Windahl, S. H., Swanson, C., & Sjögren, K. (2010) · Journal of Molecular Endocrinology · doi:10.1677/jme-09-0165 · Cited by 47 · see citing works
Bone mass and lifetime physical activity in Flemish males: a 27-year follow-up study
Delvaux, K., Lefevre, J., Philippaerts, R. M., Dequeker, J., Thomis, M. A., Vanreusel, B., Claessens, A., Eynde, B. V., Beunen, G. P., & Lysens, R. (2001) · Medicine & Science in Sports & Exercise · doi:10.1097/00005768-200111000-00011 · Cited by 46 · see citing works
Goemaere, S., Pottelbergh, I. V., Zmierczak, H., Toye, K. R. C., Daems, M., Demuynck, R., Myny, H., Bacquer, D. D., & Kaufman, J. (2001) · Bone · doi:10.1016/s8756-3282(01)00503-8 · Cited by 44 · see citing works
Self-citationTaxel, P., FALL, P. M., Albertsen, P. C., Dowsett, R. D., Trahiotis, M., Zimmerman, J., Ohannessian, C. M., & Raisz, L. G. (2002) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2002-020539 · Cited by 41 · see citing works
Henríquez, M. S., Jódar, E., Arbelo, E., Domı́nguez, C., Saavedra, P., Torres, A., SALIDO, E. C., de Tejada, M. J. G., & Hernández, D. (2003) · Journal of Clinical Densitometry · doi:10.1385/jcd:6:3:297 · Cited by 32 · see citing works
Fujiyoshi, A., Polgreen, L. E., Hurley, D. L., Gross, M. D., Sidney, S., & Jacobs, D. R. (2013) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2013-2198 · Cited by 21 · see citing works
Monitoring time interval for pQCT-derived bone outcomes in postmenopausal women
Duckham, R. L., Frank-Wilson, A. W., Johnston, J. D., Olszynski, W. P., & Kontulainen, S. A. (2013) · Osteoporosis International · doi:10.1007/s00198-012-2242-0 · Cited by 20 · see citing works
Rinaldi, G., Wisniewski, C. A., Setty, N., & LeBoff, M. S. (2011) · Journal of Clinical Densitometry · doi:10.1016/j.jocd.2011.05.002 · Cited by 18 · see citing works
The impact of accurate positioning on measurements made by peripheral QCT in the distal radius
Marjanovic, E. J., Ward, K. A., & Adams, J. E. (2008) · Osteoporosis International · doi:10.1007/s00198-008-0778-9 · Cited by 12 · see citing works
Bone turnover markers in patients with prostate carcinoma: influence of sex steroids levels
Varsavsky, M., Reyes‐García, R., García‐Martin, A., Rozas-Moreno, P., González-Ramírez, R., & Muñoz‐Torres, M. (2013) · Journal of Bone and Mineral Metabolism · doi:10.1007/s00774-013-0466-5 · Cited by 5 · see citing works
Lapauw, B., Taes, Y., Bogaert, Vanbillemont, G., Goemaere, S., Zmierczak, H., Bacquer, D. D., & Kaufman, J. (2009) · Ghent University Academic Bibliography (Ghent University) · Cited by 3 · see citing works
Self-citation
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Almeida, M., Laurent, M. R., Dubois, V., Claessens, F., O'Brien, C. A., Bouillon, R., Vanderschueren, D., & Manolagas, S. C. (2017) · Physiological Reviews · doi:10.1152/physrev.00033.2015 · Cited by 860 · see citing works
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Tangpricha, V., & den Heijer, M. (2016) · The Lancet Diabetes and Endocrinology · doi:10.1016/s2213-8587(16)30319-9 · Cited by 170 · see citing works
Vlot, M. C., Klink, D. T., den Heijer, M., Blankenstein, M. A., Rotteveel, J., & Heijboer, A. C. (2016) · Bone · doi:10.1016/j.bone.2016.11.008 · Cited by 181 · see citing works
Hilton, E. N., & Lundberg, T. R. (2021) · Sports Medicine · doi:10.1007/s40279-020-01389-3 · Cited by 170 · see citing works
Harper, J., O'Donnell, E., Sorouri Khorashad, B., McDermott, H., & Witcomb, G. L. (2021) · British Journal of Sports Medicine · doi:10.1136/bjsports-2020-103106 · Cited by 167 · see citing works
Wiepjes, C. M., de Jongh, R. T., de Blok, C. J. M., Vlot, M. C., Lips, P. T. A. M., Twisk, J. W. R., & den Heijer, M. (2018) · Journal of Bone and Mineral Research · doi:10.1002/jbmr.3612 · Cited by 137 · see citing works
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Dekker, M. J. H. J., Wierckx, K., Caenegem, E. V., Klaver, M., Kreukels, B. P. C., Elaut, E., Fisher, A. D., van Trotsenburg, M. A. A., Schreiner, T., den Heijer, M., et al. (2016) · The Journal of Sexual Medicine · doi:10.1016/j.jsxm.2016.03.371 · Cited by 132 · see citing works
Self-citationOspina, N. S., Maraka, S., Rodríguez‐Gutiérrez, R., Davidge-Pitts, C. J., Nippoldt, T. B., Prokop, L. J., & Murad, M. H. (2017) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2017-01642 · Cited by 121 · see citing works
Wiik, A., Lundberg, T. R., Rullman, E., Andersson, D. P., Holmberg, M., Mandić, M., Brismar, T. B., Dahlqvist Leinhard, O., Chanpen, S., Flanagan, J. N., et al. (2020) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgz247 · Cited by 116 · see citing works
Spanos, C., Bretherton, I., Zajac, J. D., & Cheung, A. S. (2020) · World Journal of Diabetes · doi:10.4239/wjd.v11.i3.66 · Cited by 117 · see citing works
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D'hoore, L., & T'Sjoen, G. (2022) · Journal of Internal Medicine · doi:10.1111/joim.13441 · Cited by 106 · see citing works
Self-citationRoberts, T. A., Smalley, J., & Ahrendt, D. (2021) · British Journal of Sports Medicine · doi:10.1136/bjsports-2020-102329 · Cited by 92 · see citing works
Wiepjes, C. M., de Blok, C. J. M., Staphorsius, A. S., Nota, N. M., Vlot, M. C., de Jongh, R. T., & den Heijer, M. (2019) · Journal of Bone and Mineral Research · doi:10.1002/jbmr.3862 · Cited by 88 · see citing works
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Fighera, T. M., da Silva, E., Lindenau, J. D., & Spritzer, P. M. (2018) · Clinical Endocrinology · doi:10.1111/cen.13607 · Cited by 78 · see citing works
Fighera, T. M., Ziegelmann, P. K., da Silva, T. R., & Spritzer, P. M. (2019) · Journal of the Endocrine Society · doi:10.1210/js.2018-00413 · Cited by 78 · see citing works
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Self-citationTack, L. J. W., Craen, M., Lapauw, B., Goemaere, S., Toye, K., Kaufman, J.-M., Vandewalle, S., T’Sjoen, G., Zmierczak, H.-G., & Cools, M. (2018) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2017-02316 · Cited by 63 · see citing works
Self-citationRosen, H. N., Hamnvik, O. R., Jaisamrarn, U., Malabanan, A. O., Safer, J. D., Tangpricha, V., Wattanachanya, L., & Yeap, S. S. (2019) · Journal of Clinical Densitometry · doi:10.1016/j.jocd.2019.07.004 · Cited by 63 · see citing works
Coutin, A., Wright, S. R., Li, C., & Fung, R. (2018) · Canadian Medical Education Journal · doi:10.36834/cmej.42906 · Cited by 62 · see citing works
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Tack, L. J. W., Heyse, R., Craen, M., Dhondt, K., Bossche, H. V., Laridaen, J., & Cools, M. (2017) · The Journal of Sexual Medicine · doi:10.1016/j.jsxm.2017.03.251 · Cited by 52 · see citing works
Health considerations for transgender women and remaining unknowns: a narrative review
Iwamoto, S. J., Defreyne, J., Rothman, M. S., Schuylenbergh, J. V., de Bruaene, L. V., Motmans, J., & T'Sjoen, G. G. (2019) · Therapeutic Advances in Endocrinology and Metabolism · doi:10.1177/2042018819871166 · Cited by 53 · see citing works
Self-citationFord, K., Huggins, E., & Sheean, P. (2022) · Journal of Human Nutrition and Dietetics · doi:10.1111/jhn.13027 · Cited by 70 · see citing works
Gender-Affirming Hormone Treatment Decreases Bone Turnover in Transwomen and Older Transmen
Vlot, M. C., Wiepjes, C. M., de Jongh, R. T., T'Sjoen, G. G., Heijboer, A. C., & den Heijer, M. (2019) · Journal of Bone and Mineral Research · doi:10.1002/jbmr.3762 · Cited by 46 · see citing works
Self-citationLundberg, T. R., Tucker, R., McGawley, K., Williams, A. G., Millet, G. P., Sandbakk, Ø. B., Howatson, G., Brown, G. A., Carlson, L. A., Chantler, S., et al. (2024) · Scandinavian Journal of Medicine and Science in Sports · doi:10.1111/sms.14581 · Cited by 47 · see citing works
van der Loos, M. A. T. C., Hellinga, I., Vlot, M. C., Klink, D. T., den Heijer, M., & Wiepjes, C. M. (2020) · Journal of Bone and Mineral Research · doi:10.1002/jbmr.4262 · Cited by 44 · see citing works
Insulin resistance in transgender individuals correlates with android fat mass
Bretherton, I., Spanos, C., Leemaqz, S., Premaratne, G., Grossmann, M., Zajac, J. D., & Cheung, A. S. (2021) · Therapeutic Advances in Endocrinology and Metabolism · doi:10.1177/2042018820985681 · Cited by 42 · see citing works
Cocchetti, C., Romani, A., Collet, S., Greenman, Y., Schreiner, T., Wiepjes, C. M., den Heijer, M., T'Sjoen, G. G., & Fisher, A. D. (2022) · Journal of Clinical Medicine · doi:10.3390/jcm11071784 · Cited by 39 · see citing works
Self-citationHernández, P., Bradford, J. C., Brahmachary, P. P., Ulman, S. M., Robinson, J. L., June, R. K., & Cucchiarini, M. (2024) · Osteoarthritis and Cartilage · doi:10.1016/j.joca.2024.04.015 · Cited by 41 · see citing works
Caenegem, E. V., & T'Sjoen, G. G. (2015) · Current Opinion in Endocrinology Diabetes and Obesity · doi:10.1097/med.0000000000000202 · Cited by 36 · see citing works
Self-citationMedical considerations in the care of transgender and gender diverse patients with eating disorders
Riddle, M. C., & Safer, J. D. (2022) · Journal of Eating Disorders · doi:10.1186/s40337-022-00699-3 · Cited by 35 · see citing works
Osteoporosis and Bone Health in Transgender Individuals
Verroken, C., Collet, S., Lapauw, B., & T'Sjoen, G. G. (2022) · Calcified Tissue International · doi:10.1007/s00223-022-00972-2 · Cited by 33 · see citing works
Self-citationDobrolińska, M. M., van der Tuuk, K., Vink, P., van den Berg, M., Schuringa, A., Monroy‐Gonzalez, A. G., García, D. V., Schultz, W. C. M. W., & Slart, R. H. J. A. (2019) · The Journal of Sexual Medicine · doi:10.1016/j.jsxm.2019.06.006 · Cited by 32 · see citing works
Rozga, M., Linsenmeyer, W. R., Wood, J. C., Darst, V., & Gradwell, E. (2020) · Clinical Nutrition ESPEN · doi:10.1016/j.clnesp.2020.08.011 · Cited by 33 · see citing works
Bone health in transgender people: a narrative review
Giacomelli, G., & Meriggiola, M. C. (2022) · Therapeutic Advances in Endocrinology and Metabolism · doi:10.1177/20420188221099346 · Cited by 32 · see citing works
Care of the Transgender Athlete
Dubon, M. E., Abbott, K. E., & Carl, R. L. (2018) · Current Sports Medicine Reports · doi:10.1249/jsr.0000000000000545 · Cited by 28 · see citing works
Ceolin, C., Scala, A., Dall’Agnol, M., Ziliotto, C., Delbarba, A., Facondo, P., Citron, A., Vescovi, B., Pasqualini, S., Giannini, S., et al. (2023) · Journal of Endocrinological Investigation · doi:10.1007/s40618-023-02156-7 · Cited by 23 · see citing works
Boogers, L. S., Reijtenbagh, S. J. P., Wiepjes, C. M., van Trotsenburg, A. S. P., den Heijer, M., & Hannema, S. E. (2023) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgad750 · Cited by 23 · see citing works
Cirrincione, L. R., Winston‐McPherson, G. N., Rongitsch, J., Sadílková, K., Drees, J. C., Krasowski, M. D., Dickerson, J. A., & Greene, D. N. (2021) · LGBT Health · doi:10.1089/lgbt.2020.0249 · Cited by 22 · see citing works
Rosenberg, S., Tilley, P. J. M., & Morgan, J. (2019) · Sexuality & Culture · doi:10.1007/s12119-019-09601-x · Cited by 22 · see citing works
Hamidi, O., & Davidge-Pitts, C. J. (2019) · Endocrinology and Metabolism Clinics of North America · doi:10.1016/j.ecl.2019.02.001 · Cited by 23 · see citing works
Davidge-Pitts, C. J., & Clarke, B. L. (2019) · Maturitas · doi:10.1016/j.maturitas.2019.05.002 · Cited by 21 · see citing works
Gender-affirming hormonal therapy for transgender and gender-diverse people—A narrative review
Defreyne, J., Stichele, C. V., Iwamoto, S. J., & T'Sjoen, G. G. (2022) · Best Practice & Research Clinical Obstetrics & Gynaecology · doi:10.1016/j.bpobgyn.2022.102296 · Cited by 21 · see citing works
Self-citationWiepjes, C. M., Vlot, M. C., de Blok, C. J. M., Nota, N. M., de Jongh, R. T., & den Heijer, M. (2019) · Bone · doi:10.1016/j.bone.2019.06.029 · Cited by 20 · see citing works
Gava, G., Armillotta, F., Pillastrini, P., Giagio, S., Alvisi, S., Mancini, I., Morselli, P. G., Seracchioli, R., & Meriggiola, M. C. (2021) · The Journal of Sexual Medicine · doi:10.1016/j.jsxm.2020.12.015 · Cited by 18 · see citing works
Nolan, B. J., & Cheung, A. S. (2020) · Transgender Health · doi:10.1089/trgh.2020.0077 · Cited by 17 · see citing works
Hormonal Management for Transfeminine Individuals
Abramowitz, J. D., & Tangpricha, V. (2018) · Clinics in Plastic Surgery · doi:10.1016/j.cps.2018.03.003 · Cited by 13 · see citing works
Bone health of transgender adults: what the radiologist needs to know
Stowell, J. T., Garner, H. W., Herrmann, S., Tilson, K., & Stanborough, R. O. (2020) · Skeletal Radiology · doi:10.1007/s00256-020-03511-y · Cited by 13 · see citing works
Ceolin, C., Scala, A., Scagnet, B., Citron, A., Vilona, F., RUI, M. D., Miscioscia, M., Camozzi, V., Ferlin, A., Sergi, G., et al. (2024) · Frontiers in Endocrinology · doi:10.3389/fendo.2024.1496160 · Cited by 12 · see citing works
Type 2 17-β Hydroxysteroid Dehydrogenase as a Novel Target for the Treatment of Osteoporosis
Soubhye, J., Alard, I. C., Antwerpen, P. V., & Dufrasne, F. (2015) · Future Medicinal Chemistry · doi:10.4155/fmc.15.74 · Cited by 11 · see citing works
Transgender Individuals and Osteoporosis Prevention
Sedlak, C. A., Roller, C. G., van Dulmen, M. H. M., Alharbi, H. A., Sanata, J. D., Leifson, M. A., Veney, A. J., Alhawatmeh, H. N., & Doheny, M. O. (2017) · Orthopaedic Nursing · doi:10.1097/nor.0000000000000364 · Cited by 11 · see citing works
Alvares, L. A. M., Quaresma, M. V. L. D. S., Nakamoto, F. P., Santos, L. M., Navarro, L. S., Navarro, G. S., Orozco, B. M. M., Sá, B. M. C., Achkar, G. B., Marques, C. G., et al. (2025) · British Journal of Sports Medicine · doi:10.1136/bjsports-2024-108601 · Cited by 9 · see citing works
Musculoskeletal health considerations for the transgender athlete
Birnbaum, A., Karamitopoulos, M. S., & Carter, C. W. (2022) · The Physician and Sportsmedicine · doi:10.1080/00913847.2022.2057787 · Cited by 10 · see citing works
Gois, Í., Rodrigues, F. B., Pereira, M. E., Dias-da-Silva, M. R., & Gomes, S. M. (2025) · Reviews in Endocrine and Metabolic Disorders · doi:10.1007/s11154-025-09985-2 · Cited by 10 · see citing works
Hamilton, B., Guppy, F. M., & Pitsiladis, Y. P. (2023) · Sports Medicine · doi:10.1007/s40279-023-01928-8 · Cited by 10 · see citing works
The impact of gender-affirming hormone therapy on nutrition-relevant biochemical measures
Waters, J., & Linsenmeyer, W. R. (2024) · Frontiers in Nutrition · doi:10.3389/fnut.2024.1339311 · Cited by 10 · see citing works
Endocrine Care of Transgender Adults
Fishman, S. L., Paliou, M., Poretsky, L., & Hembree, W. C. (2019) · Contemporary Endocrinology · doi:10.1007/978-3-030-05683-4_8 · Cited by 9 · see citing works
Iwamoto, S. J., Rice, J. D., Moreau, K. L., Cornier, M., Wierman, M. E., Mancuso, M. P., Gebregzabheir, A., Hammond, D. B., & Rothman, M. S. (2024) · Journal of Clinical & Translational Endocrinology · doi:10.1016/j.jcte.2024.100348 · Cited by 7 · see citing works
Getting old in the desired gender: a systematic review on aging diseases in transgender people
Ceolin, C., Papa, M. V., Scala, A., Sergi, G., & Garolla, A. (2024) · Journal of Endocrinological Investigation · doi:10.1007/s40618-024-02353-y · Cited by 7 · see citing works
Sieczkowska, S. M., Mazzolani, B. C., Coimbra, D. R., Longobardi, I., Casale, A. R., da Hora, J. D. F. V. M. P., Roschel, H., & Gualano, B. (2026) · British Journal of Sports Medicine · doi:10.1136/bjsports-2025-110239 · Cited by 8 · see citing works
Venkatesh, V. S., Nie, T., Golub, S. B., Stok, K. S., Hemmatian, H., Desai, R., Handelsman, D. J., Zajac, J. D., Grossmann, M., & Davey, R. A. (2024) · Bone · doi:10.1016/j.bone.2024.117143 · Cited by 7 · see citing works
Estrogens, the be-all and end-all of male hypogonadal bone loss?
Laurent, M. R., Gielen, E., & Vanderschueren, D. (2014) · Osteoporosis International · doi:10.1007/s00198-014-2865-4 · Cited by 7 · see citing works
Qin, P., Song, Y., Huang, Z., Yu, H., Xu, H., Ye, X., Gao, L., Gong, J., & Tian, X. (2024) · Lipids in Health and Disease · doi:10.1186/s12944-024-02131-y · Cited by 6 · see citing works
Estradiol Concentrations for Adequate Gender-Affirming Feminizing Therapy: A Systematic Review
Winston‐McPherson, G. N., Thomas, T. A., Krasowski, M. D., Ahmed, S. B., Cirrincione, L. R., Katzman, B. M., Pierre, C. C., Rytz, C. L., Miranda, K. T., Goldstein, Z. G., et al. (2025) · LGBT Health · doi:10.1089/lgbt.2024.0407 · Cited by 6 · see citing works
Clinical Concerns on Sex Steroids Variability in Cisgender and Transgender Women Athletes
Luigi, L. D., Greco, E. A., FOSSATI, C., Aversa, A., Sgrò, P., & Antinozzi, C. (2022) · International Journal of Sports Medicine · doi:10.1055/a-1909-1196 · Cited by 7 · see citing works
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Goodrich, E., Walcott, Q. A., Dallman, J., Crow, H., & Templeton, K. J. (2023) · JBJS Reviews · doi:10.2106/jbjs.rvw.23.00123 · Cited by 6 · see citing works
Hamilton, B., Hu, K., Guppy, F. M., & Pitsiladis, Y. P. (2024) · Translational Exercise Biomedicine · doi:10.1515/teb-2024-0017 · Cited by 6 · see citing works
Bone health in adult trans persons: an update of the literature
Wiepjes, C. M., den Heijer, M., & T'Sjoen, G. G. (2019) · Current Opinion in Endocrinology Diabetes and Obesity · doi:10.1097/med.0000000000000502 · Cited by 6 · see citing works
Self-citationHarper, J. M., Blagrove, R. C., Hunsicker, E., Witcomb, G. L., Ferguson, R. A., & O’Donnell, E. (2025) · European Journal of Sport Science · doi:10.1002/ejsc.70036 · Cited by 5 · see citing works
Venkatesh, V. S., Nie, T., Zajac, J. D., Grossmann, M., & Davey, R. A. (2023) · Current Osteoporosis Reports · doi:10.1007/s11914-023-00818-2 · Cited by 5 · see citing works
Three cases highlighting possible discrepancies in the interpretation of transgender DXA scores
Torre, S. C. D. L., Godar, C. M., Shakir, M. K. M., & Hoang, T. D. (2024) · Clinical Case Reports · doi:10.1002/ccr3.8451 · Cited by 4 · see citing works
Cirrincione, L. R., & Narla, R. R. (2020) · The Journal of Applied Laboratory Medicine · doi:10.1093/jalm/jfaa213 · Cited by 5 · see citing works
Nørlund, M. K., Christensen, L. L., Andersen, M., Kristensen, T. T., Frystyk, J., Mathiesen, J., Nielsen, J. L., & Glintborg, D. (2025) · Andrology · doi:10.1111/andr.70058 · Cited by 5 · see citing works
Brown, A., Montagner-Moraes, S., Hu, K., Singh, J., Charlton, L., Barrett, J., & Hamilton, B. (2025) · International Journal of Transgender Health · doi:10.1080/26895269.2025.2590036 · Cited by 4 · see citing works
Chronic liver disease and hepatology care in transgender and gender diverse populations
Nguyen, T. D., Jackson, W. E., Roth, N. C., Cinque, F., Sarkar, M., Samala, N. R., Lee, R. S., Strauss, A. T., Wisocky, J., Patel, K., et al. (2026) · The Lancet. Gastroenterology & hepatology · doi:10.1016/s2468-1253(25)00287-0 · Cited by 6 · see citing works
Bascharon, R. A., Sethi, N. K., Estevez, R., Gordon, M., Guevara, C., Twohey, E. E., & deWeber, K. (2023) · The Physician and Sportsmedicine · doi:10.1080/00913847.2023.2286943 · Cited by 4 · see citing works
Hilton, E. N., & Lundberg, T. R. (2020) · Preprints.org · doi:10.20944/preprints202005.0226.v1 · Cited by 4 · see citing works
SPORTS AND PERFORMANCE IN THE TRANSGENDER POPULATION: A SYSTEMATIC REVIEW AND META-ANALYSIS
Nahon, R. L., da Silva, A. P. S., Muniz‐Santos, R., de Novaes, R. C. T., & Pedroso, L. S. P. L. (2021) · Revista Brasileira de Medicina do Esporte · doi:10.1590/1517-8692202127062021_0054 · Cited by 3 · see citing works
Cardiopulmonary Exercise Testing in Transgender and Gender-Diverse Patients
Cortes-Puentes, G. A., Allison, T. G., Davidge-Pitts, C. J., González, C. A., Bonikowske, A. R., Lim, K. G., & Kennedy, C. C. (2024) · CHEST Pulmonary · doi:10.1016/j.chpulm.2024.100040 · Cited by 2 · see citing works
Elisabetta, V., Selvaggi, G., & Milani, C. (2025) · Forensic Science Medicine and Pathology · doi:10.1007/s12024-025-01030-7 · Cited by 2 · see citing works
Pessoas trans no desporto: regras de elegibilidade, desafios e resistências
Santos, A. L. (2024) · Revista de Estudios de Género La Ventana · doi:10.32870/lv.v7i59.7684 · Cited by 2 · see citing works
Osteoporosis in men: what is similar and what is different?
Laurent, M. R., Gielen, E., ORWOLL, E. S., & Vanderschueren, D. (2020) · Elsevier eBooks · doi:10.1016/b978-0-12-813073-5.00025-3 · Cited by 2 · see citing works
Hayes-Lattin, M., Krivicich, L. M., Bragg, J. T., Rogerson, A. L., & Salzler, M. J. (2024) · British Journal of Sports Medicine · doi:10.1136/bjsports-2023-107703 · Cited by 1 · see citing works
Ceolin, C., Dall'Agnol, M., Termini, G., Papa, M. V., Casali, G., Bertocco, A. G., Scala, A., Giannini, S., Ferlin, A., Sergi, G., et al. (2025) · Journal of Endocrinological Investigation · doi:10.1007/s40618-025-02675-5 · Cited by 1 · see citing works
Talathi, R., Juhász, V., Delgado, M., Quinaglia, T., Ghamari, A., Wang, M., Alhallak, I., Stinebaugh, S. J., Campbell, S., Stockman, S. L., et al. (2025) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgaf665 · Cited by 1 · see citing works
Ceolin, C., Savino, S., Gregorio, C., Beraldo, G., Dall’Agnol, M., Termini, G., Vetrano, D. L., Scala, A., Ferlin, A., Sergi, G., et al. (2025) · Endocrine Practice · doi:10.1016/j.eprac.2025.12.012 · Cited by 1 · see citing works
de la Londe, J. G., Aïm-Eusébi, A., Cadwallader, D., Rincon, G., Cadwallader, J., & Aubert, J. P. (2023) · Archives of Sexual Behavior · doi:10.1007/s10508-023-02655-x · Cited by 1 · see citing works
Influence of androgen receptor on bone health in transgender adults: insights from the COMET study
Ceolin, C., Scala, A., Rocca, M. S., Scagnet, B., Marton, M., Simonato, C., Ziliotto, C., RUI, M. D., Camozzi, V., Giannini, S., et al. (2025) · Journal of Endocrinological Investigation · doi:10.1007/s40618-024-02522-z · Cited by 1 · see citing works
Primary and Preventative Care for Transgender Patients
Wolf-Gould, C., & Wolf-Gould, C. S. (2020) · Elsevier eBooks · doi:10.1016/b978-0-323-49642-1.00012-0 · Cited by 1 · see citing works
O’Connor, M. I. (2024) · Clinical Orthopaedics and Related Research · doi:10.1097/corr.0000000000003004 · Cited by 1 · see citing works
Qin, P., Huang, Z., Yu, H., Xu, H., Song, Y., Ye, X., Tian, X. Y., Gong, J., & Gao, L. (2024) · Research Square · doi:10.21203/rs.3.rs-3990306/v1 · Cited by 1 · see citing works
Do transgender patients on hormone replacement have a lower incidence of osteoporosis?
Mounsey, A., & Faulk, M. (2018) · Evidence-Based Practice · doi:10.1097/ebp.0000000000000091
Hormonothérapie féminisante chez les femmes transgenres
Johnson, N., & Chabbert‐Buffet, N. (2020) · La Presse Médicale Formation · doi:10.1016/j.lpmfor.2020.10.030
Salute ossea negli adulti transgender
Federici, S., Falchetti, A., Chiodini, I., & Bonadonna, S. (2021) · L Endocrinologo · doi:10.1007/s40619-021-00956-8
Bone Health in the Transgenders
Miedany, Y. M. E. (2022) · Springer eBooks · doi:10.1007/978-3-030-87950-1_6
Endocrine Treatment of Transgender Youth
Klink, D. T. (2022) · doi:10.1093/med/9780198870197.003.0198
Bone mineral density in a sample of Mexican trans women
Martínez, J. R. A., Lazarevich, I., & Hernández, L. L. O. (2023) · Mexican Journal of Medical Research ICSA · doi:10.29057/mjmr.v11i21.9648
- Authors
- Van Caenegem, E., Wierckx, K., Taes, Y., Schreiner, T., Vandewalle, S., Toye, K., Kaufman, J.-M., & T’Sjoen, G.
- Affiliations
- Ghent University Hospital (BE)
- Oslo University Hospital (NO)
- Venue
- Osteoporosis International
- Published
- 2014-11-07
- Volume
- 26
- Issue
- 1
- Pages
- 35-47
- ISSN
- 0937-941X (ISSN-L)
- 1433-2965
- OpenAlex
- W2064274788
- Cited by
- 116
- References
- 49
- Citations by year
- 2026: 5 · 2025: 16 · 2024: 18 · 2023: 13 · 2022: 12 · 2021: 6 · 2020: 12 · 2019: 16 · 2018: 7 · 2017: 4 · 2016: 4 · 2015: 2 · 2014: 1
- FWCI
- 3.80
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Osteoporosis International (publishedVersion)
- PubMed (publishedVersion)
- Ghent University Academic Bibliography (Ghent University) (submittedVersion)
- Topics
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
- Social Sciences › Psychology › Social Psychology › LGBTQ Health, Identity, and Policy
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
- Keywords
- transgender women, bone mineral density, volumetric bone density, bone geometry, bone turnover, muscle mass loss, muscle strength, estradiol valerate, cyproterone acetate, skeletal health, fat mass
- MeSH terms
- Adult, Body Composition, Estradiol, Female, Humans, Insulin-Like Growth Factor I, Male, Middle Aged, Motor Activity, Prospective Studies, Transsexualism, Vitamin D, Absorptiometry, Photon, Bone Density, Case-Control Studies, Bone Remodeling, Muscle, Skeletal, Leptin, Muscle Strength, Gender-Affirming Procedures
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