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Bone Health in the Transgender Population

  • Treating Bone loss in challenging situations
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Clinical Reviews in Bone and Mineral Metabolism Aims and scope Submit manuscript

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.

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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).

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Authors and Affiliations

  1. Division of Endocrinology, Metabolism & Diabetes, University of Colorado School of Medicine, Anschutz Medical Campus, 12801 East 17th Avenue, Mail Stop: 8106, Aurora, CO, 80045, USA

    Micol S. Rothman & Sean J. Iwamoto

  2. Division of Endocrinology, Rocky Mountain Regional VA Medical Center, Aurora, CO, USA

    Sean J. Iwamoto

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Correspondence to Micol S. Rothman.

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Rothman, M.S., Iwamoto, S.J. Bone Health in the Transgender Population. Clinic Rev Bone Miner Metab 17, 77–85 (2019). https://doi.org/10.1007/s12018-019-09261-3

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