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Cited by 116Hormonal and reproductive studiesLGBTQ Health, Identity, and PolicySports Performance and Training

The DOI matches its Crossref record; 35 of the 35 references it cites were found in a registry or an index.

Muscle Strength, Size, and Composition Following 12 Months of Gender-affirming Treatment in Transgender Individuals

Wiik, Anna, Lundberg, Tommy R, Rullman, Eric, Andersson, Daniel P, Holmberg, Mats, Mandić, Mirko, Brismar, Torkel B, Dahlqvist Leinhard, Olof, Chanpen, Setareh, Flanagan, John N, Arver, Stefan, Gustafsson, Thomas·2020·The Journal of Clinical Endocrinology & Metabolism
DOI 10.1210/clinem/dgz247
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Abstract

Context: As many sports are divided in male/female categories, governing bodies have formed regulations on the eligibility for transgender individuals to compete in these categories. Yet, the magnitude of change in muscle mass and strength with gender-affirming treatment remains insufficiently explored. Objective: This study explored the effects of gender-affirming treatment on muscle function, size, and composition during 12 months of therapy. Design, settings, participants: In this single-center observational cohort study, untrained transgender women (TW, n = 11) and transgender men (TM, n = 12), approved to start gender-affirming medical interventions, underwent assessments at baseline, 4 weeks after gonadal suppression of endogenous hormones but before hormone replacement, and 4 and 12 months after treatment initiation. Main outcome measures: Knee extensor and flexor strength were assessed at all examination time points, and muscle size and radiological density (using magnetic resonance imaging and computed tomography) at baseline and 12 months after treatment initiation. Results: Thigh muscle volume increased (15%) in TM, which was paralleled by increased quadriceps cross-sectional area (CSA) (15%) and radiological density (6%). In TW, the corresponding parameters decreased by –5% (muscle volume) and –4% (CSA), while density remained unaltered. The TM increased strength over the assessment period, while the TW generally maintained their strength levels. Conclusions: One year of gender-affirming treatment resulted in robust increases in muscle mass and strength in TM, but modest changes in TW. These findings add new knowledge on the magnitude of changes in muscle function, size, and composition with cross-hormone therapy, which could be relevant when evaluating the transgender eligibility rules for athletic competitions.

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Metadata

Authors
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., Arver, S., & Gustafsson, T.
Affiliations
  • Karolinska University Hospital (SE)
  • AMRA Medical AB, Linköping, Sweden
Corresponding author
Lundberg, Tommy R
ORCID
Venue
The Journal of Clinical Endocrinology & Metabolism
Publisher
The Endocrine Society
Published
2019-12-03
Volume
105
Issue
3
Pages
e805-e813
ISSN
  • 0021-972X (ISSN-L)
  • 1945-7197
DOI
10.1210/clinem/dgz247
OpenAlex
W2992734117
Cited by
116
References
35
Citations by year
2026: 10 · 2025: 20 · 2024: 16 · 2023: 25 · 2022: 24 · 2021: 12 · 2020: 9
FWCI
9.13
Type
journal article
Language
en
Open access
closed
Licence
academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
Locations
  • The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
  • PubMed (publishedVersion)
Funders
Stockholm County Council (20160337, K0138-2015)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
  • Social Sciences › Psychology › Social Psychology › LGBTQ Health, Identity, and Policy
  • Health Sciences › Medicine › Orthopedics and Sports Medicine › Sports Performance and Training
Keywords
gender-affirming hormone therapy, transgender women, transgender men, muscle strength, muscle size, muscle composition, thigh muscle volume, quadriceps cross-sectional area, muscle density, gonadal suppression, sports eligibility, transgender athletes
MeSH terms
Adult, Female, Humans, Male, Transsexualism, Cohort Studies, Treatment Outcome, Muscle, Skeletal, Hormone Replacement Therapy, Muscle Strength, Sex Reassignment Procedures, Gender-Affirming Procedures

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