J Bone Metab.  2021 Feb;28(1):59-66. 10.11005/jbm.2021.28.1.59.

Effect of Cross-Sex Hormones on Body Composition, Bone Mineral Density, and Muscle Strength in Trans Women

• Yun Y
• Kim D
• Lee ES

• KMID: 2513879
• DOI: http://doi.org/10.11005/jbm.2021.28.1.59

Abstract

Background
Cross-sex hormone therapy (CHT) changes the physical characteristics of transgender women to match their gender identity and expression. This study aimed to determine the effects of feminizing cross-sex hormones on body composition, bone mineral density (BMD) and muscle strength in transgender women.
Methods
A prospective observational study assessed 11 participants who underwent feminizing CHT. Dual energy X-ray absorptiometry (DXA), and handgrip strength were measured before CHT and after 6-months of CHT. Fat mass, lean body mass (LBM), and BMD were measured by DXA and handgrip strength was measured by hand-dynamometer.
Results
Regional body fat in the trunk, legs, and gynoid region increased by 18%, 27.4%, and 27.2%, respectively after 6 months of CHT. Total body fat increased by 16.2%, while the fat mass ratio decreased by 7.2%. Although body fat increased, the android/gynoid fat ratio decreased; BMD in the lumbar spine significantly increased by 3.9% (P=0.0051), but changes in the femoral neck (P=0.1969) and total femur (P=0.4769) were not significant. Changes in LBM ranged from -3% (trunk) to -8% (arm region). Right-hand grip strength also significantly decreased by 7.7% (P=0.0467).
Conclusions
After 6 months of CHT, transgender women showed a general increase in fat mass and a decreased in overall LBM and handgrip strength. Increase in fat mass percentage were more remarkable in gynoid region, leading to a more “female” body fat distribution.

Keyword

Body composition · Bone density · Hand strength · Hormone replacement therapy · Transgender persons