Daan M van Velzen1, Nienke M Nota1, Suat Simsek1,2, Elfi B Conemans1, Guy T'Sjoen3,4, Martin den Heijer1. 1. Division of Endocrinology, Department of Internal Medicine, Amsterdam University Medical Center, Amsterdam, The Netherlands. 2. Northwest Clinics, Department of Endocrinology, Alkmaar, The Netherlands. 3. Department of Endocrinology, Ghent University Hospital, Ghent, Belgium. 4. Center for Sexology and Gender, Ghent University Hospital, Ghent, Belgium.
Abstract
OBJECTIVE: Transgender individuals sometimes report a lack of physical change during hormone treatment, such as alterations in muscle tone or fat distribution. Identifying characteristics of this subgroup could be a step toward individualizing hormone therapy in transgender individuals. Therefore, we study the variation of changes in body composition and characteristics associated with a lack of change. DESIGN AND METHODS: Body composition measures were recorded in 323 transmen and 288 transwomen at every visit from the start of hormone therapy to a maximum of 24 months follow-up. Absence of change was defined as transmen with a decrease in lean body mass or transwomen with a decrease in fat percentage. RESULTS: A lack of change at 24 months was observed in 19 of 94 (20.2%) transmen and in 9 of 96 (9.4%) transwomen. The risk of not achieving change in body composition was related to lower testosterone levels and less suppression of LH in transmen (OR: 0.67, 95% CI: 0.48-0.94 per SD increase in testosterone and OR: 1.36, 95% CI: 1.01-1.83 per SD increase in LH). CONCLUSIONS: There is a large variation in body composition changes during hormone therapy, with a substantial proportion of individuals with no measurable effects. In transmen, serum testosterone and LH were associated with a lack of change, but serum hormone levels were not associated with body composition changes in transwomen. The results provide a rationale for individualizing hormone therapy in transmen, by considering individual effects rather than solely relying on a standardized dosage of hormone therapy.
OBJECTIVE: Transgender individuals sometimes report a lack of physical change during hormone treatment, such as alterations in muscle tone or fat distribution. Identifying characteristics of this subgroup could be a step toward individualizing hormone therapy in transgender individuals. Therefore, we study the variation of changes in body composition and characteristics associated with a lack of change. DESIGN AND METHODS: Body composition measures were recorded in 323 transmen and 288 transwomen at every visit from the start of hormone therapy to a maximum of 24 months follow-up. Absence of change was defined as transmen with a decrease in lean body mass or transwomen with a decrease in fat percentage. RESULTS: A lack of change at 24 months was observed in 19 of 94 (20.2%) transmen and in 9 of 96 (9.4%) transwomen. The risk of not achieving change in body composition was related to lower testosterone levels and less suppression of LH in transmen (OR: 0.67, 95% CI: 0.48-0.94 per SD increase in testosterone and OR: 1.36, 95% CI: 1.01-1.83 per SD increase in LH). CONCLUSIONS: There is a large variation in body composition changes during hormone therapy, with a substantial proportion of individuals with no measurable effects. In transmen, serum testosterone and LH were associated with a lack of change, but serum hormone levels were not associated with body composition changes in transwomen. The results provide a rationale for individualizing hormone therapy in transmen, by considering individual effects rather than solely relying on a standardized dosage of hormone therapy.
Authors: Marieke Tebbens; Annemieke C Heijboer; Guy T'Sjoen; Peter H Bisschop; Martin den Heijer Journal: J Clin Endocrinol Metab Date: 2022-01-18 Impact factor: 5.958
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Authors: Milou Cecilia Madsen; Martin den Heijer; Claudia Pees; Nienke R Biermasz; Leontine E H Bakker Journal: Endocr Connect Date: 2022-07-25 Impact factor: 3.221