Cross-sex pattern of bone mineral density in early onset gender identity disorder.
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.
Haraldsen
I R
IR
Department of Neuropsychiatry and Psychosomatic Medicine, University of Oslo, The National Hospital, 0027 Oslo, Norway. i.h.haraldsen@psykiatri.uio.no
Haug
E
E
Falch
J
J
Egeland
T
T
Opjordsmoen
S
S
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
D012739:Gonadal Steroid Hormones; D013739:Testosterone; D004997:Ethinyl Estradiol; C004648:testosterone enanthate