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Bone Health in the Transgender Population

  • Micol S. RothmanEmail author
  • Sean J. Iwamoto
Treating Bone loss in challenging situations
  • 31 Downloads
Part of the following topical collections:
  1. Treating Bone loss in challenging situations

Abstract

It is well known that sex steroids, particularly estrogen, play a crucial role in the attainment and maintenance of peak bone density in all people. Transgender (trans) have been frequently observed to have low bone density prior to initiation of gender-affirming hormone therapy, while trans men generally do not. With pharmacologic estrogen, many studies show improving bone density in trans women. With pharmacologic testosterone, bone density in trans men remains largely unchanged although androgens have indirect effects on bone health via changes in fat and lean mass. Much remains unknown about best practices to optimize bone health, interpret DXA scans and assess fracture risk in trans adults.

Keywords

Osteoporosis Transgender Sex steroids Body composition DXA Puberty blockade 

Notes

Acknowledgements

The authors would like to thank Prof. Dr. Guy T'Sjoen and Dr. Chantal Wiepjes for their assistance in reviewing the figures. We would also like to thank Dr. Carol Zapalowski for reviewing the manuscript.

Funding

Advanced Fellowship in Geriatrics from the Geriatric Research, Education, and Clinical Center, VA Eastern Colorado Health Care System, Rocky Mountain Regional VA Medical Center (SJI).

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they no conflict of interest.

Ethical Approval

N/A

Informed Consent

N/A

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Division of Endocrinology, Metabolism & DiabetesUniversity of Colorado School of MedicineAuroraUSA
  2. 2.Division of EndocrinologyRocky Mountain Regional VA Medical CenterAuroraUSA

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