{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T03:21:03Z","timestamp":1777951263130,"version":"3.51.4"},"reference-count":34,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2024,10,11]],"date-time":"2024-10-11T00:00:00Z","timestamp":1728604800000},"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":[[2026,2,1]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>Several studies demonstrate endogenous androgen excess in adult trans male patients, but data are lacking in adolescents. Identifying hyperandrogenism in growing children is relevant, as it can be the first sign of serious adrenal conditions and can be associated with advanced skeletal maturity and premature growth cessation. We sought to identify the percentage of adolescent trans male patients who, prior to gender affirming treatment, had biochemical hyperandrogenism relative to reference ranges and to a comparison group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We conducted a retrospective chart review of patients seen between 2013 and 2020 at an academic pediatric center with a multidisciplinary gender team. Participants included 177 trans male patients and 166 cisgender female patients who underwent endocrine evaluation and 11 trans males and 15 cisgender females who completed adrenocorticotropic hormone (ACTH) stimulation tests for hyperandrogenism. We analyzed differences in androgen levels, bone ages, and adult heights.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Eighty-eight of 172 (51.2%) trans males tested exhibited elevations of one or more androgens compared to 24\/158 (15.2%) cisgender females (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.0001). Trans males were more likely than cisgender females to have elevated dehydroepiandrostenedione (DHEA) (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.0056) and dehydroepiandrostenedione sulfate (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.0005) levels compared to age-adjusted reference ranges. Trans males displayed significantly higher DHEA responses to ACTH (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.019), more advanced bone ages (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.00014), and lower median adult height (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.001) compared to cisgender females.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>A higher percentage of trans male patients had elevated levels of adrenal steroids, more advanced bone ages, and lower median adult heights compared to cisgender females.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/trgh.2023.0246","type":"journal-article","created":{"date-parts":[[2024,10,11]],"date-time":"2024-10-11T21:38:29Z","timestamp":1728682709000},"page":"45-54","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Elevated Adrenal Steroids, Advanced Bone Ages, and Skewed Adult Heights in Trans Male Adolescents: Indications for Comprehensive Evaluation"],"prefix":"10.1177","volume":"11","author":[{"given":"Jill D.","family":"Jacobson","sequence":"first","affiliation":[{"name":"Division of Endocrinology and Diabetes, Department of Pediatrics, Children\u2019s Mercy Kansas City, Kansas City, Missouri, USA."},{"name":"University of Missouri-Kansas City School of Medicine, Kansas City, Missouri, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily L.","family":"Paprocki","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Diabetes, Department of Pediatrics, Children\u2019s Mercy Kansas City, Kansas City, Missouri, USA."},{"name":"University of Missouri-Kansas City School of Medicine, Kansas City, Missouri, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kelsee L.","family":"Halpin","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Diabetes, Department of Pediatrics, Children\u2019s Mercy Kansas City, Kansas City, Missouri, USA."},{"name":"University of Missouri-Kansas City School of Medicine, Kansas City, Missouri, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Uttam","family":"Garg","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, Children\u2019s Mercy Kansas City, Kansas City, Missouri, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2588-8961","authenticated-orcid":false,"given":"Michelle M.","family":"Knoll","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Diabetes, Department of Pediatrics, Children\u2019s Mercy Kansas City, Kansas City, Missouri, USA."},{"name":"University of Missouri-Kansas City School of Medicine, Kansas City, Missouri, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2024,10,11]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.1993.tb01013.x"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/del474"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1743-6109.2011.02252.x"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.endonu.2014.01.010"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0306-4530(97)00033-4"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1023\/a:1024506427497"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2019.00829"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1136\/adc.64.11.1554"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1159\/000509548"},{"key":"e_1_3_3_11_2","volume-title":"ICD-10-CM 2022 the Complete Official Codebook with Guidelines","author":"American Medical Association","year":"2021","unstructured":"American Medical Association. 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The prevalence of polycystic ovary syndrome in adolescents: A systematic review and meta-analysis. 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