Effects of gender affirming hormone therapy on body mass index in transgender individuals: A longitudinal cohort study

• Type of Material: Article
• Authors: Pichatorn Suppakitjanusant, Mahidol University; Yuhan Ji, Rollins School of Public Health; Mary Stevenson, Emory University; Panicha Chantrapanichkul, Mahidol University; R. Craig Sineath, Oregon Health and Science University; Michael Goodman, Emory University; Jessica Alvarez, Emory University; Vin Tangpricha, Emory University
• Language: English
• Date: 2020-09-01
• Publisher: Elsevier
• Publication Version: Final Published Version
• Copyright Statement: © 2020 Published by Elsevier Inc.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.jcte.2020.100230
• Title of Journal or Parent Work: Journal of Clinical and Translational Endocrinology
• Volume: 21
• Start Page: 100230
• End Page: 100230
• Grant/Funding Information: This study was funded in part by the Prince Mahidol Foundation, National Institutes of Health R21HD076387 from the Eunice Kennedy Shriver National Institute of Child Health, United States; Human Development, United States; The National Center for Advancing Translational Sciences of the National Institutes of Health, United States, under Award Number UL1TR002378. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
• Keywords: Gender affirming hormone therapy; Body mass index; Transgender
• Research Categories: Psychology, Developmental; Health Sciences, Medicine and Surgery; Gender Studies

Abstract

Introduction: Many transgender people take hormone therapy to affirm their gender identity. One potential long-term consequence of gender affirming hormone therapy is increased body mass index (BMI), which may be associated with metabolic syndrome, cardiovascular disease and higher mortality. Only a few published studies explored changes in BMI in transgender people taking gender affirming hormone therapy (GAHT). Objective: To examine the changes in BMI longitudinally in response to GAHT in transgender women and men. Methods: We conducted a retrospective cohort study of transgender individuals who received GAHT from the endocrinology clinic between January 1, 2000 and September 6, 2018. Subjects who sought GAHT were included if they had two separate measurements of BMI and were excluded if they had a BMI greater than 35 kg/m2 or were missing demographic data at entry. We used a linear mixed model to analyze the longitudinal change in BMI. Results: There were a total of 227 subjects included in this cohort. Among subjects already on GAHT, transgender women were receiving GAHT longer than transgender men (6.59 ± 9.35 vs 3.67 ± 3.43 years, p-value = 0.04). Over the period of 7 years, there was a significant increase in BMI in transwomen who newly initiated GAHT (p-value 0.004). There were no changes in BMI in transgender men and women already on GAHT or in transgender men who newly initiated GAHT in the study. Conclusion: We conclude that BMI significantly increases in transwomen but not in transmen after initiation of GAHT in a single center based in the United States. In transwomen and transmen, BMI appears to be stable following 3 to 6 years of GAHT. Future investigations should examine the causes for increased BMI in transgender women including type of GAHT, diet and lifestyle, and association with risk of metabolic syndrome and cardiovascular disease.