To investigate weight, body mass index (BMI), and lipid profiles in a national cohort of transgender adolescents starting hormone therapy (HT) before 18 years of age.
Key Findings:
26.8% of trans boys and 5.7% of trans girls were overweight before HT initiation.
22.0% of trans boys and 5.7% of trans girls were obese before HT initiation.
High percentages of dyslipidemia were observed: total cholesterol (12.5% trans boys, 6.1% trans girls), LDL (21.8% trans boys, 12.5% trans girls), and triglycerides (3.4% trans boys, 6.3% trans girls).
During GnRHa monotherapy, weight SDS showed a trend toward decline, but BMI SDS and lipid profiles did not change consistently.
After initiation of sex steroids, trans boys showed decreased weight SDS, BMI SDS, and HDL, while triglycerides increased; trans girls showed an increase in HDL.
Interpretation:
Overweight, obesity, and dyslipidemia were common in transgender adolescents before HT initiation, with slight worsening of dyslipidemia during sex steroid therapy in trans boys but not in trans girls, highlighting the need for ongoing cardiovascular risk monitoring.
Limitations:
The study is observational and may not establish causation.
Sample size may limit the generalizability of findings.
Potential biases inherent in observational studies.
Conclusion:
While BMI did not deteriorate significantly, dyslipidemia worsened slightly during sex steroid therapy in trans boys, indicating a need for ongoing monitoring of cardiovascular risk factors in both transgender boys and girls undergoing HT.
by Kjersti Kvernebo Sunnergren, Pernille Badsberg Norup, Mette Ewers Haahr, Annamaria Giraldi, Anne Katrine Pagsberg, Peter Christiansen, Lise Aksglaede, Line Cleemann, Anders Juul, Katharina M Main
