Osteoporosis and Bone Health in Transgender Persons

• Type of Material: Article
• Authors: Vin Tangpricha, Emory University; Mary Stevenson, Emory University
• Language: English
• Date: 2019-06-01
• Publisher: W. B. Saunders Co-Elsevier Inc.
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2019 Elsevier Inc. All rights reserved.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.ecl.2019.02.006
• Title of Journal or Parent Work: Endocrinology and Metabolism Clinics of North America
• Volume: 48
• Issue: 2
• Start Page: 421
• End Page: +
• Grant/Funding Information: Supported by the National Center for Advancing Translational Sciences of the National Institutes of Health under Award Number UL1TR002378
• Keywords: Testosterone; Life Sciences & Biomedicine; Trans persons; Osteoporosis; Transsexual persons; Endocrinology & Metabolism; Hormone therapy; Mass; Gender affirmation; Vitamin D; Follow-up; Estrogen receptor gene; Mineral density; Dual-energy x-ray absorptiometry; Transgender; Science & Technology; Therapy; Body composition; Bone density
• Research Categories: Health Sciences, Public Health; Biology, Anatomy; Biology, Genetics; Health Sciences, Rehabilitation and Therapy

Abstract

This review summarizes current studies, systematic reviews, and clinical practice guidelines regarding the screening, diagnosis, and treatment of osteoporosis in transgender persons. Gender-affirming hormone therapy has been shown to maintain or promote acquisition of bone density as measured by dual-energy x-ray absorptiometry. No differences in fracture rates have been seen in trans women or men in short, prospective trials. Trans children and adolescents on gonadotropin-releasing hormone may be at risk for decreasing bone density while not on sex steroid hormone replacement. Screening for osteoporosis should be based on clinical factors. Treatment for osteoporosis follows the same guidelines as cisgender populations.