Study of Effects of Gender-Affirming Hormone Therapy on Bone Mineral Density in Individuals with Gender Dysphoria.

Indian Journal of Endocrinology and Metabolism Pub Date : 2023-11-01 Epub Date: 2024-01-11 DOI:10.4103/ijem.ijem_265_23

Rakesh Bobba, Pramila Kalra, Mala Dharmalingam

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Abstract

Introduction: Gender affirming hormone therapy (GAHT) is the mainstay treatment in transitioning individuals and has positive physical and psychological effects. Among the things to monitor in transgender patients on long-term hormones, bone health is an essential consideration. As the calcium intake in the Indian population is less, and many gender-incongruent individuals may not take adequate calcium in their diet, we needed data on the bone health of Indians with gender dysphoria as the information available globally may not apply to our population.

Materials and methods: The study was performed to assess bone mineral density in individuals with gender dysphoria who were on gender-affirming hormonal therapy for at least 6 months. It was a hospital-based cross-sectional study of bone mineral density measured at two sites - hip and spine in individuals with gender dysphoria on GAHT for at least six months.

Results: A total of 30 individuals were included in this study. The mean age of individuals with Gender dysphoria was found to be 28.17 ± 6.15 years, and the age range was 19-42 years. Out of the 30 individuals, 14 were transgender males, and the remaining 16 were transgender females. Bone mineral density at the hip and spine in transgender males was 1.047 ± 0.124 g/cm² and 1.065 ± 0.115 g/cm², which was better compared to transgender females in whom the bone mineral density at hip and spine was 0.899 ± 0.873 g/cm² and 0.854 ± 0.099 g/cm² (P = 0.001 for hip; P = 0.000 for spine). The Z score at hip and spine were better in transgender males as compared to transgender females (P < 0.001 for hip; P < 0.001 for spine) when compared to genetic sex and at the spine (P = 0.001) when compared to affirmed sex. In this study, we observed that the transgender females who underwent orchidectomy had a lower mean Z score at spine compared to individuals who did not undergo the procedure.

Conclusions: The current study results indicate that GAHT does have positive effects on bone health in transmen.

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性别确认激素疗法对性别异常者骨矿物质密度影响的研究。

导言：性别平权激素疗法（GAHT）是变性人的主要治疗方法，对生理和心理都有积极的影响。在对长期使用激素的变性患者进行监测时，骨骼健康是一个重要的考虑因素。由于印度人的钙摄入量较少，而且许多性别不一致的人在饮食中可能没有摄入足够的钙，因此我们需要有关患有性别障碍的印度人骨骼健康的数据，因为全球现有的信息可能并不适用于我们的人群：该研究旨在评估接受性别确认激素治疗至少 6 个月的性别失调患者的骨矿物质密度。这是一项以医院为基础的横断面研究，在髋关节和脊柱两个部位测量接受性别确认激素治疗至少 6 个月的性别认知障碍患者的骨矿物质密度：共有 30 人参与了这项研究。性别焦虑症患者的平均年龄为（28.17 ± 6.15）岁，年龄范围为 19-42 岁。在这 30 人中，14 人为变性男性，其余 16 人为变性女性。变性男性髋部和脊柱的骨矿密度分别为 1.047 ± 0.124 g/cm2 和 1.065 ± 0.115 g/cm2，优于变性女性，后者髋部和脊柱的骨矿密度分别为 0.899 ± 0.873 g/cm2 和 0.854 ± 0.099 g/cm2（髋部为 P = 0.001；脊柱为 P = 0.000）。与遗传性别相比，变性男性髋部和脊柱的 Z 值优于变性女性（髋部 P < 0.001；脊柱 P < 0.001）；与肯定性别相比，变性男性脊柱的 Z 值优于变性女性（P = 0.001）。在这项研究中，我们观察到，与未接受睾丸切除术的人相比，接受睾丸切除术的变性女性脊柱的平均 Z 评分较低：目前的研究结果表明，GAHT 对变性人的骨骼健康有积极影响。

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来源期刊

Indian Journal of Endocrinology and Metabolism Medicine-Endocrinology, Diabetes and Metabolism

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2.10

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0.00%

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期刊介绍： The Indian Journal of Endocrinology and Metabolism (IJEM) aims to function as the global face of Indian endocrinology research. It aims to act as a bridge between global and national advances in this field. The journal publishes thought-provoking editorials, comprehensive reviews, cutting-edge original research, focused brief communications and insightful letters to editor. The journal encourages authors to submit articles addressing aspects of science related to Endocrinology and Metabolism in particular Diabetology. Articles related to Clinical and Tropical endocrinology are especially encouraged. Sub-topic based Supplements are published regularly. This allows the journal to highlight issues relevant to Endocrine practitioners working in India as well as other countries. IJEM is free access in the true sense of the word, (it charges neither authors nor readers) and this enhances its global appeal.