{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T21:32:28Z","timestamp":1781818348723,"version":"3.54.5"},"reference-count":39,"publisher":"Elsevier BV","issue":"2","license":[{"start":{"date-parts":[[2019,6,1]],"date-time":"2019-06-01T00:00:00Z","timestamp":1559347200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2019,6,1]],"date-time":"2019-06-01T00:00:00Z","timestamp":1559347200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"funder":[{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["UL1TR002378"],"award-info":[{"award-number":["UL1TR002378"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","theclinics.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Endocrinology and Metabolism Clinics of North America"],"published-print":{"date-parts":[[2019,6]]},"DOI":"10.1016\/j.ecl.2019.02.006","type":"journal-article","created":{"date-parts":[[2019,3,23]],"date-time":"2019-03-23T03:24:59Z","timestamp":1553311499000},"page":"421-427","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":42,"title":["Osteoporosis and Bone Health in Transgender Persons"],"prefix":"10.1016","volume":"48","author":[{"given":"Mary O.","family":"Stevenson","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vin","family":"Tangpricha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.ecl.2019.02.006_bib1","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1080\/15532739.2011.700873","article-title":"Standards of care for the health of transsexual, transgender, and gender-nonconforming people, version 7","volume":"13","author":"Coleman","year":"2012","journal-title":"Int J Transgend"},{"issue":"11","key":"10.1016\/j.ecl.2019.02.006_bib2","doi-asserted-by":"crossref","first-page":"3869","DOI":"10.1210\/jc.2017-01658","article-title":"Endocrine treatment of gender-dysphoric\/gender-incongruent persons: an endocrine society clinical practice guideline","volume":"102","author":"Hembree","year":"2017","journal-title":"J\u00a0Clin Endocrinol Metab"},{"key":"10.1016\/j.ecl.2019.02.006_bib3","series-title":"How many adults identify as transgender in the United States?","author":"Flores","year":"2016"},{"key":"10.1016\/j.ecl.2019.02.006_bib4","first-page":"275","article-title":"Skeletal effects of estrogen","volume":"15","author":"Turner","year":"1994","journal-title":"Endocr Rev"},{"issue":"10","key":"10.1016\/j.ecl.2019.02.006_bib5","doi-asserted-by":"crossref","first-page":"4576","DOI":"10.1210\/jcem.86.10.7960","article-title":"Sexual dimorphism in skeletal size, density, and strength","volume":"89","author":"Seeman","year":"2001","journal-title":"J\u00a0Clin Endocrinol Metab"},{"key":"10.1016\/j.ecl.2019.02.006_bib6","doi-asserted-by":"crossref","first-page":"1548","DOI":"10.1359\/jbmr.0810c","article-title":"Estrogen and fracture risk in men","volume":"23","author":"Gennari","year":"2008","journal-title":"J\u00a0Bone Miner Res"},{"key":"10.1016\/j.ecl.2019.02.006_bib7","doi-asserted-by":"crossref","first-page":"1056","DOI":"10.1056\/NEJM199410203311604","article-title":"Estrogen resistance caused by a mutation in the estrogen receptor gene in a man","volume":"331","author":"Smith","year":"1994","journal-title":"N\u00a0Engl J Med"},{"key":"10.1016\/j.ecl.2019.02.006_bib8","first-page":"3689","article-title":"Aromatase deficiency in male and female siblings caused by a novel mutation and the physiological role of estrogens","volume":"80","author":"Morishima","year":"1995","journal-title":"J\u00a0Clin Endocrinol Metab"},{"key":"10.1016\/j.ecl.2019.02.006_bib9","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1056\/NEJM199707103370204","article-title":"Effect of testosterone and estradiol in a man with aromatase deficiency","volume":"337","author":"Carani","year":"1997","journal-title":"N\u00a0Engl J Med"},{"key":"10.1016\/j.ecl.2019.02.006_bib10","doi-asserted-by":"crossref","first-page":"2386","DOI":"10.1210\/jcem.82.8.4163","article-title":"Long-term effect of testosterone therapy on bone mineral density in hypogonadal men","volume":"82","author":"Behre","year":"1997","journal-title":"J\u00a0Clin Endocrinol Metab"},{"key":"10.1016\/j.ecl.2019.02.006_bib11","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1001\/jamainternmed.2016.9539","article-title":"Effect of testosterone treatment on volumetric bone density and strength in older men with low testosterone: a controlled clinical trial","volume":"177","author":"Snyder","year":"2017","journal-title":"JAMA Intern Med"},{"key":"10.1016\/j.ecl.2019.02.006_bib12","doi-asserted-by":"crossref","first-page":"776","DOI":"10.1210\/jcem-69-4-776","article-title":"Increases in bone density during treatment of men with idiopathic hypogonadotropic hypogonadism","volume":"69","author":"Finkelstein","year":"1989","journal-title":"J\u00a0Clin Endocrinol Metab"},{"key":"10.1016\/j.ecl.2019.02.006_bib13","doi-asserted-by":"crossref","first-page":"1043","DOI":"10.1002\/jbmr.5650110802","article-title":"Estrogen, cytokines, and pathogenesis of postmenopausal osteoporosis","volume":"11","author":"Pacifici","year":"1996","journal-title":"J\u00a0Bone Miner Res"},{"issue":"4","key":"10.1016\/j.ecl.2019.02.006_bib14","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1210\/er.2001-5002","article-title":"Meta-analyses of therapies for postmenopausal osteoporosis. V. Meta-analysis of the efficacy of hormone replacement therapy in treating and preventing osteoporosis in postmenopausal women","volume":"23","author":"Wells","year":"2002","journal-title":"Endocr Rev"},{"issue":"3","key":"10.1016\/j.ecl.2019.02.006_bib16","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1016\/j.jocd.2015.06.013","article-title":"Executive summary of the 2015 ISCD position development conference on advanced measures from DXA and QCT: fracture prediction beyond BMD","volume":"18","author":"Shepherd","year":"2015","journal-title":"J\u00a0Clin Densitom"},{"issue":"10","key":"10.1016\/j.ecl.2019.02.006_bib17","doi-asserted-by":"crossref","first-page":"2359","DOI":"10.1007\/s00198-014-2794-2","article-title":"Clinician\u2019s guide to prevention and treatment of osteoporosis","volume":"25","author":"Cosman","year":"2014","journal-title":"Osteoporos Int"},{"key":"10.1016\/j.ecl.2019.02.006_bib18","series-title":"Assessment of fracture risk and its application to screening for postmenopausal osteoporosis: report of a WHO study group [meeting held in Rome from 22 to 25 June 1992]","author":"World Health Organization","year":"1994"},{"issue":"1","key":"10.1016\/j.ecl.2019.02.006_bib19","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1016\/j.bone.2013.01.039","article-title":"Low bone mass is prevalent in male-to-female transsexual persons before the start of cross-sex hormonal therapy and gonadectomy","volume":"54","author":"Van Caenegem","year":"2013","journal-title":"Bone"},{"issue":"11","key":"10.1016\/j.ecl.2019.02.006_bib20","doi-asserted-by":"crossref","first-page":"3904","DOI":"10.1210\/jc.2017-01642","article-title":"Effect of sex steroids on the bone health of transgender individuals: a systematic review and meta-analysis","volume":"102","author":"Singh-Ospina","year":"2017","journal-title":"J\u00a0Clin Endocrinol Metab"},{"key":"10.1016\/j.ecl.2019.02.006_bib21","doi-asserted-by":"crossref","first-page":"817","DOI":"10.1359\/jbmr.060312","article-title":"Women's Health Initiative Investigators: effects of conjugated equine estrogen on risk of fractures and BMD in postmenopausal women with hysterectomy: results from the women's health initiative randomized trial","volume":"21","author":"Jackson","year":"2006","journal-title":"J\u00a0Bone Miner Res"},{"key":"10.1016\/j.ecl.2019.02.006_bib22","doi-asserted-by":"crossref","first-page":"1016","DOI":"10.1016\/j.bone.2008.09.001","article-title":"Body composition, volumetric and areal bone parameters in male-to-female transsexual persons","volume":"43","author":"Lapauw","year":"2008","journal-title":"Bone"},{"key":"10.1016\/j.ecl.2019.02.006_bib23","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1385\/JCD:6:3:297","article-title":"Bone mass, bone turnover, vitamin D, and estrogen receptor gene polymorphisms in male to female transsexuals: effects of estrogenic treatment on bone metabolism of the male","volume":"6","author":"Sosa","year":"2003","journal-title":"J\u00a0Clin Densitom"},{"key":"10.1016\/j.ecl.2019.02.006_bib24","series-title":"Prevention and management of osteoporosis: report of a WHO scientific group","author":"World Health Organization","year":"2003"},{"issue":"7","key":"10.1016\/j.ecl.2019.02.006_bib25","doi-asserted-by":"crossref","first-page":"2503","DOI":"10.1210\/jc.2012-1187","article-title":"Bone mass, bone geometry, and body composition in female-to-male transsexual persons after long-term cross-sex hormonal therapy","volume":"97","author":"Van Caenegem","year":"2012","journal-title":"J\u00a0Clin Endocrinol Metab"},{"key":"10.1016\/j.ecl.2019.02.006_bib26","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1016\/j.yhbeh.2007.05.012","article-title":"Cross-sex pattern of bone mineral density in early onset gender identity disorder","volume":"52","author":"Haraldsen","year":"2007","journal-title":"Horm Behav"},{"issue":"5","key":"10.1016\/j.ecl.2019.02.006_bib27","doi-asserted-by":"crossref","first-page":"560","DOI":"10.1111\/j.1365-2265.2004.02125.x","article-title":"Testosterone increases bone mineral density in female-to-male transsexuals: a case series of 15 subjects","volume":"61","author":"Turner","year":"2004","journal-title":"Clin Endocrinol (Oxf)"},{"key":"10.1016\/j.ecl.2019.02.006_bib28","first-page":"1999","article-title":"Cross-sex hormone therapy in trans persons is safe and effective at short-time follow-up: results from the European network for the investigation of gender incongruence","volume":"1","author":"Wierckx","year":"2014","journal-title":"J\u00a0Sex Med"},{"issue":"3","key":"10.1016\/j.ecl.2019.02.006_bib29","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1046\/j.1365-2265.1998.00396.x","article-title":"Long- term follow-up of bone mineral density and bone metabolism in transsexuals treated with cross-sex hormones","volume":"48","author":"van Kesteren","year":"1998","journal-title":"Clin Endocrinol (Oxf)"},{"key":"10.1016\/j.ecl.2019.02.006_bib30","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1016\/S0378-5122(96)01073-0","article-title":"Effects of hormone deficiency, androgen therapy and calcium supplementation on bone mineral density in female transsexuals","volume":"26","author":"Goh","year":"1997","journal-title":"Maturitas"},{"issue":"6","key":"10.1016\/j.ecl.2019.02.006_bib31","doi-asserted-by":"crossref","first-page":"1252","DOI":"10.1002\/jbmr.3102","article-title":"Bone mineral density increases in trans persons after 1 year of hormonal treatment: a multicenter prospective observational study","volume":"32","author":"Wiepjes","year":"2017","journal-title":"J\u00a0Bone Miner Res"},{"issue":"7","key":"10.1016\/j.ecl.2019.02.006_bib32","doi-asserted-by":"crossref","first-page":"1911","DOI":"10.1210\/jc.2011-0385","article-title":"Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline","volume":"96","author":"Holick","year":"2011","journal-title":"J\u00a0Clin Endocrinol Metab"},{"key":"10.1016\/j.ecl.2019.02.006_bib33","doi-asserted-by":"crossref","DOI":"10.4158\/PS-2018-0050","article-title":"The use of vitamins and minerals in skeletal health: American Association of Clinical Endocrinology (AACE\/ACE) position statement","author":"Hurley","year":"2018","journal-title":"Endocr Pract"},{"issue":"2","key":"10.1016\/j.ecl.2019.02.006_bib34","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1123\/jpah.2017-0298","article-title":"the levels and predictors of physical activity engagement within the treatment-seeking transgender population: a matched control study","volume":"15","author":"Jones","year":"2018","journal-title":"J\u00a0Phys Act Health"},{"issue":"3","key":"10.1016\/j.ecl.2019.02.006_bib35","doi-asserted-by":"crossref","first-page":"137","DOI":"10.3934\/publichealth.2014.3.137","article-title":"Nutritional status and obesity prevalence in people with gender dysphoria","volume":"1","author":"Vilas","year":"2014","journal-title":"AIMS Public Health"},{"issue":"2","key":"10.1016\/j.ecl.2019.02.006_bib36","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1530\/EJE-17-0496","article-title":"Changes in regional body fat, lean body mass and body shape in trans persons using cross-sex hormonal therapy: results from a multicenter prospective study","volume":"178","author":"Klaver","year":"2018","journal-title":"Eur J Endocrinol"},{"issue":"2","key":"10.1016\/j.ecl.2019.02.006_bib37","doi-asserted-by":"crossref","first-page":"E270","DOI":"10.1210\/jc.2014-2439","article-title":"Bone mass in young adulthood following gonadotropin-releasing hormone analog treatment and cross-sex hormone treatment in adolescents with gender dysphoria","volume":"100","author":"Klink","year":"2015","journal-title":"J\u00a0Clin Endocrinol Metab"},{"key":"10.1016\/j.ecl.2019.02.006_bib38","first-page":"1","article-title":"Assessment of fracture risk and its application to screening for postmenopausal osteoporosis","volume":"843","author":"World Health Organization","year":"1994","journal-title":"World Health Organ Tech Rep Ser"},{"key":"10.1016\/j.ecl.2019.02.006_bib39","doi-asserted-by":"crossref","first-page":"1","DOI":"10.4158\/EP161435.GL","article-title":"American Association of Clinical Endocrinologists and American College of Endocrinology clinical practice guidelines for the diagnosis and treatment of postmenopausal osteoporosis - 2016","volume":"22","author":"Camacho","year":"2016","journal-title":"Endocr Pract"},{"key":"10.1016\/j.ecl.2019.02.006_bib40","doi-asserted-by":"crossref","first-page":"734","DOI":"10.1016\/j.bone.2009.01.373","article-title":"FRAX and its applications to clinical practice","volume":"44","author":"Kanis","year":"2009","journal-title":"Bone"}],"container-title":["Endocrinology and Metabolism Clinics of North America"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0889852919300118?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0889852919300118?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T09:44:14Z","timestamp":1760175854000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0889852919300118"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,6]]},"references-count":39,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2019,6]]}},"alternative-id":["S0889852919300118"],"URL":"https:\/\/doi.org\/10.1016\/j.ecl.2019.02.006","relation":{},"ISSN":["0889-8529"],"issn-type":[{"value":"0889-8529","type":"print"}],"subject":[],"published":{"date-parts":[[2019,6]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Osteoporosis and Bone Health in Transgender Persons","name":"articletitle","label":"Article Title"},{"value":"Endocrinology and Metabolism Clinics of North America","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.ecl.2019.02.006","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2019 Elsevier Inc. All rights reserved.","name":"copyright","label":"Copyright"}]}}