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01-05-2022 | Osteoporosis | Review

Osteoporosis and Bone Health in Transgender Individuals

Authors: Charlotte Verroken, Sarah Collet, Bruno Lapauw, Guy T’Sjoen

Published in: Calcified Tissue International | Issue 5/2022

Abstract

This review discusses the changes in bone mass, structure, and metabolism that occur upon gender-affirming hormonal treatment (GAHT) in transgender adults and adolescents, as well as their clinical relevance. In general, available evidence shows that GAHT in transgender adults is not associated with major bone loss. In transgender adolescents, pubertal suppression with gonadotropin-releasing hormone agonist monotherapy impairs bone development, but at least partial recovery is observed after GAHT initiation. Nevertheless, a research gap remains concerning fracture risk and determinants of bone strength other than bone mineral density. Attention for bone health is warranted especially in adult as well as adolescent trans women, given the relatively high prevalence of low bone mass both before the start of treatment and after long-term GAHT in this population. Strategies to optimize bone health include monitoring of treatment compliance and ensuring adequate exposure to administered sex steroids, in addition to general bone health measures such as adequate physical activity, adequate vitamin D and calcium intake, and a healthy lifestyle. When risk factors for osteoporosis exist the threshold to perform DXA should be low, and treatment decisions should be based on the same guidelines as the general population.

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Title: Osteoporosis and Bone Health in Transgender Individuals
Authors: Charlotte Verroken
Sarah Collet
Bruno Lapauw
Guy T’Sjoen
Publication date: 01-05-2022
Publisher: Springer US
Keywords: Osteoporosis
Osteoporosis
Published in: Calcified Tissue International / Issue 5/2022
Print ISSN: 0171-967X
Electronic ISSN: 1432-0827
DOI: https://doi.org/10.1007/s00223-022-00972-2

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