Adrián Carrasco Munera
Specialist in Family and Community Medicine and member of the LGTBIQ+ Health Group of the Madrid Society of Family and Community Medicine
This is a cohort study to assess bone mineralisation in trans patients who started hormone blockade in adolescence and then hormone treatment to bring their pubertal development in line with their gender identity.
The study uses bone densitometry of the hip and lumbar spine (commonly used to assess bone mineralisation), showing that hormone blockade and hormone treatment are safe to achieve the expected bone density with pubertal development.
Hormone treatment in trans adolescents has been shown to be safe for bone health. Hip densitometry has been adequate in both testosterone- and oestrogen-treated boys, girls and non-binary adolescents with blockers and hormone treatment show adequate bone health in their hips.
On the other hand, in the assessment of lumbar spine densitometry there have been lower than expected results in patients who were assigned as 'male' at birth, suggesting that protocols need to be revised to avoid underachievement of oestrogen levels necessary for bone mineralisation. The authors acknowledge several methodological limitations in this regard and propose to extend the study in this population to corroborate these results and pave the way for better hormonal management in people who use testosterone in their adolescent transition.
In summary, the study brings good news regarding the safety of hormonal management of trans adolescence and invites further improvement.