Development of Hip Bone Geometry in Transgender Adolescents Resembles the Experienced Gender if GnRHa Treatment Is Started in Early, but Not Late, Puberty
Bone geometry can be described in terms of periosteal and endocortical growth and is partly determined by sex steroids. Periosteal and endocortical apposition are thought to be regulated by testosterone and estrogen, respectively. Gender-affirming hormone (GAH) treatment with sex steroids in transge...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Oxford University Press
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8265905/ http://dx.doi.org/10.1210/jendso/bvab048.1606 |
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author | van der Loos, Maria A T C Hellinga, Ilse Vlot, Mariska C Klink, Daniel T Den Heijer, Martin Wiepjes, Chantal M |
author_facet | van der Loos, Maria A T C Hellinga, Ilse Vlot, Mariska C Klink, Daniel T Den Heijer, Martin Wiepjes, Chantal M |
author_sort | van der Loos, Maria A T C |
collection | PubMed |
description | Bone geometry can be described in terms of periosteal and endocortical growth and is partly determined by sex steroids. Periosteal and endocortical apposition are thought to be regulated by testosterone and estrogen, respectively. Gender-affirming hormone (GAH) treatment with sex steroids in transgender people might affect bone geometry. However, in adult transgender people no change in bone geometry during GAH was observed. In this study, we investigated changes in bone geometry among transgender adolescents using a gonadotropin-releasing hormone agonist (GnRHa) and GAH prior to achieving peak bone mass. Transgender adolescents treated with GnRHa and subsequent GAH at our center before the age of 18 years were eligible for inclusion. Participants were grouped based on their Tanner stage at the start of GnRHa treatment and divided into early, mid, and late puberty groups. Hip Strength Analysis software calculating subperiosteal width (SPW) and endocortical diameter (ED) was applied to dual-energy X-ray absorptiometry scans performed at start of GnRHa and GAH treatments, and after ≥ 2 years of GAH treatment. Mixed model analyses were performed to study differences over time. Data were visually compared with reference values of the general population retrieved from the literature. A total of 322 participants were included, of whom 106 trans women and 216 trans men. In both trans women and trans men participants resembled the reference curve for SPW and ED of the experienced gender, but only when GnRHa was started during early puberty. Those who started during mid- and late puberty remained within the reference curve of the gender assigned at birth. A possible explanation might be sought in the phenomenon of programming, which conceptualizes that stimuli during critical windows of development can have major consequences throughout one’s lifespan. Therefore, this study adds insights into sex-specific bone geometry development during puberty of transgender adolescents treated with GnRHa, as well as the general population. |
format | Online Article Text |
id | pubmed-8265905 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-82659052021-07-09 Development of Hip Bone Geometry in Transgender Adolescents Resembles the Experienced Gender if GnRHa Treatment Is Started in Early, but Not Late, Puberty van der Loos, Maria A T C Hellinga, Ilse Vlot, Mariska C Klink, Daniel T Den Heijer, Martin Wiepjes, Chantal M J Endocr Soc Reproductive Endocrinology Bone geometry can be described in terms of periosteal and endocortical growth and is partly determined by sex steroids. Periosteal and endocortical apposition are thought to be regulated by testosterone and estrogen, respectively. Gender-affirming hormone (GAH) treatment with sex steroids in transgender people might affect bone geometry. However, in adult transgender people no change in bone geometry during GAH was observed. In this study, we investigated changes in bone geometry among transgender adolescents using a gonadotropin-releasing hormone agonist (GnRHa) and GAH prior to achieving peak bone mass. Transgender adolescents treated with GnRHa and subsequent GAH at our center before the age of 18 years were eligible for inclusion. Participants were grouped based on their Tanner stage at the start of GnRHa treatment and divided into early, mid, and late puberty groups. Hip Strength Analysis software calculating subperiosteal width (SPW) and endocortical diameter (ED) was applied to dual-energy X-ray absorptiometry scans performed at start of GnRHa and GAH treatments, and after ≥ 2 years of GAH treatment. Mixed model analyses were performed to study differences over time. Data were visually compared with reference values of the general population retrieved from the literature. A total of 322 participants were included, of whom 106 trans women and 216 trans men. In both trans women and trans men participants resembled the reference curve for SPW and ED of the experienced gender, but only when GnRHa was started during early puberty. Those who started during mid- and late puberty remained within the reference curve of the gender assigned at birth. A possible explanation might be sought in the phenomenon of programming, which conceptualizes that stimuli during critical windows of development can have major consequences throughout one’s lifespan. Therefore, this study adds insights into sex-specific bone geometry development during puberty of transgender adolescents treated with GnRHa, as well as the general population. Oxford University Press 2021-05-03 /pmc/articles/PMC8265905/ http://dx.doi.org/10.1210/jendso/bvab048.1606 Text en © The Author(s) 2021. Published by Oxford University Press on behalf of the Endocrine Society. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) ), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Reproductive Endocrinology van der Loos, Maria A T C Hellinga, Ilse Vlot, Mariska C Klink, Daniel T Den Heijer, Martin Wiepjes, Chantal M Development of Hip Bone Geometry in Transgender Adolescents Resembles the Experienced Gender if GnRHa Treatment Is Started in Early, but Not Late, Puberty |
title | Development of Hip Bone Geometry in Transgender Adolescents Resembles the Experienced Gender if GnRHa Treatment Is Started in Early, but Not Late, Puberty |
title_full | Development of Hip Bone Geometry in Transgender Adolescents Resembles the Experienced Gender if GnRHa Treatment Is Started in Early, but Not Late, Puberty |
title_fullStr | Development of Hip Bone Geometry in Transgender Adolescents Resembles the Experienced Gender if GnRHa Treatment Is Started in Early, but Not Late, Puberty |
title_full_unstemmed | Development of Hip Bone Geometry in Transgender Adolescents Resembles the Experienced Gender if GnRHa Treatment Is Started in Early, but Not Late, Puberty |
title_short | Development of Hip Bone Geometry in Transgender Adolescents Resembles the Experienced Gender if GnRHa Treatment Is Started in Early, but Not Late, Puberty |
title_sort | development of hip bone geometry in transgender adolescents resembles the experienced gender if gnrha treatment is started in early, but not late, puberty |
topic | Reproductive Endocrinology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8265905/ http://dx.doi.org/10.1210/jendso/bvab048.1606 |
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