{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T02:32:40Z","timestamp":1793413960725,"version":"4.5.0"},"reference-count":38,"publisher":"The Endocrine Society","issue":"8","license":[{"start":{"date-parts":[[2023,12,21]],"date-time":"2023-12-21T00:00:00Z","timestamp":1703116800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,7,12]]},"abstract":"Abstract<\/jats:title>\n \n Context<\/jats:title>\n Transgender adolescents can undergo puberty suppression (PS) and subsequent gender-affirming hormone therapy (GAHT) but little information is available on the expected rate of physical changes.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To investigate the time course of body composition changes during PS and GAHT.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n In this study, retrospective data of 380 trans boys and 168 trans girls treated with PS prior to GAHT from a gender identity clinic were included. Total lean and fat mass Z-scores using birth-assigned sex as reference were determined using dual-energy X-ray absorptiometry.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n In trans boys, lean mass Z-scores decreased (\u22120.32, 95% CI \u22120.41; \u22120.23) and fat mass Z-scores increased (0.31, 95% CI 0.21; 0.41) in the first year of PS and remained stable thereafter. Lean mass Z-scores increased (0.92, 95% CI 0.81; 1.04) and fat mass Z-scores decreased (\u22120.43, 95% CI \u22120.57; \u22120.29) only during the first year of testosterone,. In trans girls, both lean and fat mass Z-scores gradually changed over 3 years of PS (respectively \u22121.13, 95% CI \u22121.29; \u22120.98 and 1.06, 95% CI 0.90; 1.23). In the first year of GAHT, lean mass Z-scores decreased (\u22120.19, 95% CI \u22120.36; \u22120.03) while fat mass Z-scores remained unchanged after 3 years (\u22120.02, 95% CI \u22120.20; 0.16).<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Compared with peers, trans girls experienced ongoing lean mass decrease and fat mass increase during 3 years of PS while in trans boys smaller changes were observed that stabilized after 1 year. A large increase in lean mass Z-scores occurred only during the first year of testosterone treatment. In trans girls, body composition changed only slightly during GAHT. This information can improve counseling about treatment effects.<\/jats:p>\n <\/jats:sec>","DOI":"10.1210\/clinem\/dgad750","type":"journal-article","created":{"date-parts":[[2023,12,21]],"date-time":"2023-12-21T21:24:32Z","timestamp":1703193872000},"page":"e1593-e1601","source":"Crossref","is-referenced-by-count":24,"title":["Time Course of Body Composition Changes in Transgender Adolescents During Puberty Suppression and Sex Hormone Treatment"],"prefix":"10.1210","volume":"109","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0952-9168","authenticated-orcid":false,"given":"Lidewij Sophia","family":"Boogers","sequence":"first","affiliation":[{"name":"Center of Expertise on Gender Dysphoria, Amsterdam University Medical Center location VUMC , 1081 HV Amsterdam , The Netherlands"},{"name":"Department of Endocrinology and Metabolism, and Center of Expertise on Gender Dysphoria, Amsterdam University Medical Center location VUMC , 1081 HV Amsterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sterre Johanna Petronella","family":"Reijtenbagh","sequence":"additional","affiliation":[{"name":"Center of Expertise on Gender Dysphoria, Amsterdam University Medical Center location VUMC , 1081 HV Amsterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8280-0065","authenticated-orcid":false,"given":"Chantal Maria","family":"Wiepjes","sequence":"additional","affiliation":[{"name":"Center of Expertise on Gender Dysphoria, Amsterdam University Medical Center location VUMC , 1081 HV Amsterdam , The Netherlands"},{"name":"Department of Endocrinology and Metabolism, and Center of Expertise on Gender Dysphoria, Amsterdam University Medical Center location VUMC , 1081 HV Amsterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9677-7441","authenticated-orcid":false,"given":"Adrianus Sarinus Paulus","family":"van Trotsenburg","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, and Center of Expertise on Gender Dysphoria, Amsterdam University Medical Center location VUMC , 1081 HV Amsterdam , The Netherlands"},{"name":"Department of Pediatric Endocrinology, Amsterdam University Medical Center location AMC , 1105 AZ Amsterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3620-5617","authenticated-orcid":false,"given":"Martin","family":"den Heijer","sequence":"additional","affiliation":[{"name":"Center of Expertise on Gender Dysphoria, Amsterdam University Medical Center location VUMC , 1081 HV Amsterdam , The Netherlands"},{"name":"Department of Endocrinology and Metabolism, and Center of Expertise on Gender Dysphoria, Amsterdam University Medical Center location VUMC , 1081 HV Amsterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8996-0993","authenticated-orcid":false,"given":"Sabine Elisabeth","family":"Hannema","sequence":"additional","affiliation":[{"name":"Center of Expertise on Gender Dysphoria, Amsterdam University Medical Center location VUMC , 1081 HV Amsterdam , The Netherlands"},{"name":"Department of Endocrinology and Metabolism, and Center of Expertise on Gender Dysphoria, Amsterdam University Medical Center location VUMC , 1081 HV Amsterdam , The Netherlands"},{"name":"Department of Pediatric Endocrinology, Amsterdam University Medical Center location AMC , 1105 AZ Amsterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","published-online":{"date-parts":[[2023,12,21]]},"reference":[{"issue":"11","key":"2024071216415811500_dgad750-B1","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 Clin Endocrinol Metab"},{"issue":"sup1","key":"2024071216415811500_dgad750-B2","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1080\/26895269.2022.2100644","article-title":"Standards of care for the health of transgender and gender diverse people, version 8","volume":"23","author":"Coleman","year":"2022","journal-title":"Int J Transgend Health"},{"issue":"235","key":"2024071216415811500_dgad750-B3","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1136\/adc.44.235.291","article-title":"Variations in pattern of pubertal changes in girls","volume":"44","author":"Marshall","year":"1969","journal-title":"Arch Dis Child"},{"issue":"239","key":"2024071216415811500_dgad750-B4","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1136\/adc.45.239.13","article-title":"Variations in the pattern of pubertal changes in boys","volume":"45","author":"Marshall","year":"1970","journal-title":"Arch Dis Child"},{"issue":"7","key":"2024071216415811500_dgad750-B5","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1055\/s-2007-1021081","article-title":"Cross-sectional areas of fat and muscle in limbs during growth and middle age","volume":"15","author":"Kanehisa","year":"1994","journal-title":"Int J Sports Med"},{"issue":"1","key":"2024071216415811500_dgad750-B6","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1186\/s13293-018-0189-3","article-title":"Sex differences in body composition and association with cardiometabolic risk","volume":"9","author":"Schorr","year":"2018","journal-title":"Biol Sex Differ"},{"issue":"12","key":"2024071216415811500_dgad750-B7","first-page":"4358","article-title":"Increase in bone density and lean body mass during testosterone administration in men with acquired hypogonadism","volume":"81","author":"Katznelson","year":"1996","journal-title":"J Clin Endocrinol Metab"},{"issue":"2","key":"2024071216415811500_dgad750-B8","doi-asserted-by":"crossref","first-page":"163","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":"2024071216415811500_dgad750-B9","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1530\/EJE-14-0586","article-title":"Body composition, bone turnover, and bone mass in trans men during testosterone treatment: 1-year follow-up data from a prospective case-controlled study (ENIGI)","volume":"172","author":"Van Caenegem","year":"2015","journal-title":"Eur J Endocrinol"},{"issue":"7","key":"2024071216415811500_dgad750-B10","doi-asserted-by":"crossref","first-page":"1125","DOI":"10.1016\/j.jsxm.2016.05.004","article-title":"Efficacy and safety of gonadotropin-releasing hormone agonist treatment to suppress puberty in gender dysphoric adolescents","volume":"13","author":"Schagen","year":"2016","journal-title":"J Sex Med"},{"issue":"2","key":"2024071216415811500_dgad750-B11","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1089\/trgh.2020.0029","article-title":"Body composition and markers of cardiometabolic health in transgender youth on gonadotropin-releasing hormone agonists","volume":"6","author":"Nokoff","year":"2021","journal-title":"Transgend Health"},{"issue":"2","key":"2024071216415811500_dgad750-B12","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1016\/j.jsxm.2017.12.009","article-title":"Early hormonal treatment affects body composition and body shape in young transgender adolescents","volume":"15","author":"Klaver","year":"2018","journal-title":"J Sex Med"},{"issue":"2","key":"2024071216415811500_dgad750-B13","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1093\/ejendo\/lvad116","article-title":"The dose-dependent effect of estrogen on bone mineral density in trans girls","volume":"189","author":"Boogers","year":"2023","journal-title":"Eur J Endocrinol"},{"issue":"9","key":"2024071216415811500_dgad750-B14","doi-asserted-by":"crossref","first-page":"3190","DOI":"10.1111\/j.1743-6109.2010.01912.x","article-title":"Effects of intramuscular testosterone undecanoate on body composition and bone mineral density in female-to-male transsexuals","volume":"7","author":"Mueller","year":"2010","journal-title":"J Sex Med"},{"issue":"4","key":"2024071216415811500_dgad750-B15","doi-asserted-by":"crossref","first-page":"582","DOI":"10.1016\/j.jsxm.2018.01.016","article-title":"The Amsterdam cohort of gender dysphoria study (1972-2015): trends in prevalence, treatment, and regrets","volume":"15","author":"Wiepjes","year":"2018","journal-title":"J Sex Med"},{"issue":"9","key":"2024071216415811500_dgad750-B16","doi-asserted-by":"crossref","first-page":"e3805","DOI":"10.1210\/clinem\/dgac349","article-title":"Transgender girls grow tall: adult height is unaffected by GnRH analogue and estradiol treatment","volume":"107","author":"Boogers","year":"2022","journal-title":"J Clin Endocrinol Metab"},{"issue":"3","key":"2024071216415811500_dgad750-B17","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1038\/pr.2012.189","article-title":"The world's tallest nation has stopped growing taller: the height of Dutch children from 1955 to 2009","volume":"73","author":"Sch\u00f6nbeck","year":"2013","journal-title":"Pediatr Res"},{"issue":"4","key":"2024071216415811500_dgad750-B18","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1080\/030144699282999","article-title":"Centiles of body mass index for Dutch children aged 0-20 years in 1980\u2013a baseline to assess recent trends in obesity","volume":"26","author":"Cole","year":"1999","journal-title":"Ann Hum Biol"},{"issue":"9","key":"2024071216415811500_dgad750-B19","doi-asserted-by":"crossref","first-page":"e7038","DOI":"10.1371\/journal.pone.0007038","article-title":"Dual energy X-ray absorptiometry body composition reference values from NHANES","volume":"4","author":"Kelly","year":"2009","journal-title":"PLoS One"},{"issue":"1","key":"2024071216415811500_dgad750-B20","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1002\/jbmr.3862","article-title":"Fracture risk in trans women and trans men using long-term gender-affirming hormonal treatment: a nationwide cohort study","volume":"35","author":"Wiepjes","year":"2020","journal-title":"J Bone Miner Res"},{"issue":"2","key":"2024071216415811500_dgad750-B21","first-page":"370","article-title":"Bone mineral density and body composition before and during treatment with gonadotropin-releasing hormone agonist in children with central precocious and early puberty","volume":"83","author":"Boot","year":"1998","journal-title":"J Clin Endocrinol Metab"},{"issue":"4","key":"2024071216415811500_dgad750-B22","doi-asserted-by":"crossref","first-page":"e2020039339","DOI":"10.1542\/peds.2020-039339","article-title":"Pubertal suppression, bone mass, and body composition in youth with gender dysphoria","volume":"148","author":"Navabi","year":"2021","journal-title":"Pediatrics"},{"issue":"1","key":"2024071216415811500_dgad750-B23","doi-asserted-by":"crossref","first-page":"41","DOI":"10.2165\/11319760-000000000-00000","article-title":"The influence of estrogen on skeletal muscle: sex matters","volume":"40","author":"Enns","year":"2010","journal-title":"Sports Med"},{"issue":"4","key":"2024071216415811500_dgad750-B24","doi-asserted-by":"crossref","first-page":"484","DOI":"10.1016\/j.jadohealth.2019.10.026","article-title":"Diet and physical activity behaviors among adolescent transgender students: school survey results","volume":"66","author":"Bishop","year":"2020","journal-title":"J Adolesc Health"},{"issue":"1","key":"2024071216415811500_dgad750-B25","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1210\/er.2003-0038","article-title":"Endocrine control of body composition in infancy, childhood, and puberty","volume":"26","author":"Veldhuis","year":"2005","journal-title":"Endocr Rev"},{"issue":"1","key":"2024071216415811500_dgad750-B26","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1111\/j.1749-6632.2000.tb06494.x","article-title":"Annual changes in total body fat and fat-free mass in children from 8 to 18 years in relation to changes in body mass index. The Fels longitudinal study","volume":"904","author":"Siervogel","year":"2000","journal-title":"Ann N Y Acad Sci"},{"issue":"2","key":"2024071216415811500_dgad750-B27","first-page":"583","article-title":"Effects of testosterone supplementation for 3 years on muscle performance and physical function in older men","volume":"102","author":"Storer","year":"2017","journal-title":"J Clin Endocrinol Metab"},{"issue":"5","key":"2024071216415811500_dgad750-B28","doi-asserted-by":"crossref","first-page":"811","DOI":"10.1530\/EJE-10-0952","article-title":"Testosterone but not estradiol level is positively related to muscle strength and physical performance independent of muscle mass: a cross-sectional study in 1489 older men","volume":"164","author":"Auyeung","year":"2011","journal-title":"Eur J Endocrinol"},{"issue":"12","key":"2024071216415811500_dgad750-B29","doi-asserted-by":"crossref","first-page":"e113637","DOI":"10.1371\/journal.pone.0113637","article-title":"Grip strength across the life course: normative data from twelve British studies","volume":"9","author":"Dodds","year":"2014","journal-title":"PLoS One"},{"issue":"5","key":"2024071216415811500_dgad750-B30","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1530\/EJE-20-0609","article-title":"Variation in sensitivity and rate of change in body composition: steps toward individualizing transgender care","volume":"183","author":"van Velzen","year":"2020","journal-title":"Eur J Endocrinol"},{"issue":"1","key":"2024071216415811500_dgad750-B31","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1007\/s00198-014-2805-3","article-title":"Preservation of volumetric bone density and geometry in trans women during cross-sex hormonal therapy: a prospective observational study","volume":"26","author":"Van Caenegem","year":"2015","journal-title":"Osteoporos Int"},{"issue":"15","key":"2024071216415811500_dgad750-B32","doi-asserted-by":"crossref","first-page":"865","DOI":"10.1136\/bjsports-2020-103106","article-title":"How does hormone transition in transgender women change body composition, muscle strength and haemoglobin? Systematic review with a focus on the implications for sport participation","volume":"55","author":"Harper","year":"2021","journal-title":"Br J Sports Med"},{"issue":"6","key":"2024071216415811500_dgad750-B33","doi-asserted-by":"crossref","first-page":"711","DOI":"10.1530\/EJE-19-0383","article-title":"Bone mineral density, body composition and metabolic profiles in adult women with complete androgen insensitivity syndrome and removed gonads using oral or transdermal estrogens","volume":"181","author":"Gava","year":"2019","journal-title":"Eur J Endocrinol"},{"issue":"5","key":"2024071216415811500_dgad750-B34","doi-asserted-by":"crossref","first-page":"1081","DOI":"10.1016\/j.stemcr.2022.04.001","article-title":"Prepubertal androgen signaling is required to establish male fat distribution","volume":"17","author":"Sebo","year":"2022","journal-title":"Stem Cell Reports"},{"key":"2024071216415811500_dgad750-B35","doi-asserted-by":"crossref","first-page":"846578","DOI":"10.1155\/2014\/846578","article-title":"Importance of android\/gynoid fat ratio in predicting metabolic and cardiovascular disease risk in normal weight as well as overweight and obese children","volume":"2014","author":"Samsell","year":"2014","journal-title":"J Obes"},{"issue":"9","key":"2024071216415811500_dgad750-B36","doi-asserted-by":"crossref","first-page":"826","DOI":"10.1001\/archpediatrics.2009.148","article-title":"Effect of android to gynoid fat ratio on insulin resistance in obese youth","volume":"163","author":"Aucouturier","year":"2009","journal-title":"Arch Pediatr Adolesc Med"},{"issue":"4","key":"2024071216415811500_dgad750-B37","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1253\/circrep.CR-23-0021","article-title":"Cardiovascular risk in transgender people with gender-affirming hormone treatment","volume":"5","author":"Masumori","year":"2023","journal-title":"Circ Rep"},{"issue":"10","key":"2024071216415811500_dgad750-B38","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1016\/S2213-8587(21)00185-6","article-title":"Mortality trends over five decades in adult transgender people receiving hormone treatment: a report from the Amsterdam cohort of gender dysphoria","volume":"9","author":"de Blok","year":"2021","journal-title":"Lancet Diabetes Endocrinol"}],"container-title":["The Journal of Clinical Endocrinology & Metabolism"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jcem\/advance-article-pdf\/doi\/10.1210\/clinem\/dgad750\/55142723\/dgad750.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jcem\/article-pdf\/109\/8\/e1593\/58530375\/dgad750.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jcem\/article-pdf\/109\/8\/e1593\/58530375\/dgad750.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,12]],"date-time":"2024-07-12T16:43:05Z","timestamp":1720802585000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jcem\/article\/109\/8\/e1593\/7486582"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,21]]},"references-count":38,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2023,12,21]]},"published-print":{"date-parts":[[2024,7,12]]}},"URL":"https:\/\/doi.org\/10.1210\/clinem\/dgad750","relation":{},"ISSN":["0021-972X","1945-7197"],"issn-type":[{"value":"0021-972X","type":"print"},{"value":"1945-7197","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2024,8]]},"published":{"date-parts":[[2023,12,21]]}}}