{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T03:20:39Z","timestamp":1787714439161,"version":"build-2784847793"},"reference-count":31,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2022,6,1]],"date-time":"2022-06-01T00:00:00Z","timestamp":1654041600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Transgender Health"],"published-print":{"date-parts":[[2022,6,1]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>We aimed to study determinants of bone health in transgender youth in anticipation of or shortly after initiating puberty suppression and\/or gender-affirming hormone therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      This was a retrospective review of records of transgender adolescents in our institution between June 2014 and June 2019. Dual energy X-ray absorptiometry was used to assess bone mineral density (BMD). Baseline characteristics were collected and included in a multilinear regression model to assess determinants of lumbar spine (LS) BMD Z-scores adjusted for age and height and accounting for race. Welch's\n                      <jats:italic toggle=\"yes\">t<\/jats:italic>\n                      -test was used to compare characteristics across genders.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      One hundred nineteen patient records were analyzed. Forty-six patients (38.7%) were assigned male at birth (AMAB) and 73 patients (61.3%) were assigned female at birth (AFAB). Mean (\u00b1standard deviation [SD]) age (years) was 14.7\u00b12.6 for AMAB and 15.0\u00b12.2 for AFAB. The adjusted LS BMD Z-score was lower in the AMAB population with a mean (+SD) of \u22120.605\u00b11.42 compared with 0.043\u00b11.09 in AFAB (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      =0.010). In a multivariate model, AMAB gender, vitamin D deficiency, and lower body mass index (BMI) z-scores were determinants of lower LS BMD Z-scores (\n                      <jats:italic toggle=\"yes\">R<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      =0.206). Age, race, ethnicity, insurance status, and Tanner stage were not determinants of BMD. However,\n                      <jats:italic toggle=\"yes\">post hoc<\/jats:italic>\n                      analysis did show that pubertal status modified the results.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>AMAB transgender adolescents have lower BMD compared with AFAB patients, before or shortly after starting puberty suppression and\/or gender-affirming hormone therapy. Lower BMI and vitamin D deficiency were determinants of lower BMD. Further studies are needed to explore etiology for bone health discrepancy in this population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/trgh.2020.0111","type":"journal-article","created":{"date-parts":[[2021,5,27]],"date-time":"2021-05-27T10:07:11Z","timestamp":1622110031000},"page":"213-218","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":11,"title":["Determinants of Bone Mineral Density in Transgender Youth"],"prefix":"10.1177","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7467-357X","authenticated-orcid":false,"given":"Albara","family":"Marwa","sequence":"first","affiliation":[{"name":"Division of Pediatric Endocrinology, Department of Pediatrics, UT Southwestern Medical Center, Dallas, Texas, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madhusmita","family":"Misra","sequence":"additional","affiliation":[{"name":"Division of Pediatric Endocrinology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ximena","family":"Lopez","sequence":"additional","affiliation":[{"name":"Division of Pediatric Endocrinology, Department of Pediatrics, UT Southwestern Medical Center, Dallas, Texas, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2022,6,13]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1037\/a0039906"},{"key":"e_1_3_3_3_2","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders 5th ed. 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