title: Cross-sex pattern of bone mineral density in early onset gender identity disorder.
abstract: Hormonally controlled differences in bone mineral density (BMD) between males and females are well studied. The effects of cross-sex hormones on bone metabolism in patients with early onset gender identity disorder (EO-GID), however, are unclear. We examined BMD, total body fat (TBF) and total lean body mass (TLBM) in patients prior to initiation of sex hormone treatment and during treatment at months 3 and 12. The study included 33 EO-GID patients who were approved for sex reassignment and a control group of 122 healthy Norwegians (males, n=77; females, n=45). Male patients (n=12) received an oral dose of 50 mug ethinylestradiol daily for the first 3 months and 100 mug daily thereafter. Female patients (n=21) received 250 mg testosterone enantate intramuscularly every third week. BMD, TBF and TLBM were estimated using dual energy X-ray absorptiometry (DXA). In male patients, the DXA measurements except TBF were significantly lower compared to their same-sex control group at baseline and did not change during treatment. In female patients, the DXA measurements were slightly higher than in same-sex controls at baseline and also remained unchanged during treatment. In conclusion, this study reports that body composition and bone density of EO-GID patients show less pronounced sex differences compared to controls and that bone density was unaffected by cross-sex hormone treatment.
authors.affiliation: Department of Neuropsychiatry and Psychosomatic Medicine, University of Oslo, The National Hospital, 0027 Oslo, Norway. i.h.haraldsen@psykiatri.uio.no
authors.forename: I R
authors.initials: IR
authors.lastname: Haraldsen
authors.forename: E
authors.initials: E
authors.lastname: Haug
authors.forename: J
authors.initials: J
authors.lastname: Falch
authors.forename: T
authors.initials: T
authors.lastname: Egeland
authors.forename: S
authors.initials: S
authors.lastname: Opjordsmoen
mesh_terms: D015502:Absorptiometry, Photon; D000328:Adult; D000367:Age Factors; D001823:Body Composition / Q000187:drug effects; D015519:Bone Density / Q000187:drug effects*; D001842:Bone and Bones / Q000000981:diagnostic imaging / Q000187:drug effects / Q000378:metabolism; D004997:Ethinyl Estradiol / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D005783:Gender Identity; D012739:Gonadal Steroid Hormones / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D012727:Sex Characteristics; D018709:Statistics, Nonparametric; D013739:Testosterone / Q000031:analogs & derivatives* / Q000627:therapeutic use; D014189:Transsexualism / Q000188:drug therapy* / Q000378:metabolism
chemical_list: D012739:Gonadal Steroid Hormones; D013739:Testosterone; D004997:Ethinyl Estradiol; C004648:testosterone enanthate