The DOI matches its Crossref record; 49 of the 49 references it cites were found in a registry or an index.
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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In the citing paper
“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 citing paper
“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.”
In the citing paper
“A decrease in CSA of 1.5%–11.7% was reported over periods ranging from 12 to 36 months.”
In the citing paper
“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.”
In the citing paper
“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.”
In the citing paper
“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.”
In the citing paper
“~10%–14% lower handgrip strength.17 41 60”
In the citing paper
“6.0%–11.4% lower muscle CSA”
In the citing paper
“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.”
In the citing paper
“hormone-naive transwomen demonstrate 6.4%–8.0% lower LBM,41 51”
In the citing paper
“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]
In the citing paper
“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]
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The Transgender Woman and Sport Performance
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Considerations in Care of the Transgender Orthopedic Patient
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Metadata
- 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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