Osteoporosis and Bone Health in Transgender Persons

• Authors: Vin Tangpricha, Emory University; Mary Stevenson, Emory University
• Journal Title: Endocrinology and Metabolism Clinics of North America
• Volume: Volume 48, Number 2
• Publisher: W. B. Saunders Co-Elsevier Inc. | 2019-06-01, Pages 421-+
• Type of Work: Article | Post-print: After Peer Review
• Publisher DOI: http://doi.org/10.1016/j.ecl.2019.02.006
• Subjects: Health Sciences, Public Health; Biology, Anatomy; Biology, Genetics; Health Sciences, Rehabilitation and Therapy
• Keywords: Science & Technology; Life Sciences & Biomedicine; Endocrinology & Metabolism; Osteoporosis; Bone density; Transgender; Hormone therapy; Gender affirmation; Dual-energy x-ray absorptiometry; Estrogen receptor gene; Mineral density; Transsexual persons; Body composition; Trans persons; Follow-up; Vitamin D; Therapy; Mass; Testosterone

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.