{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T03:20:40Z","timestamp":1787714440189,"version":"build-2784847793"},"reference-count":34,"publisher":"The Endocrine Society","issue":"5","license":[{"start":{"date-parts":[[2024,8,16]],"date-time":"2024-08-16T00:00:00Z","timestamp":1723766400000},"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":[[2025,4,22]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Context<\/jats:title>\n                  <jats:p>Skeletal dimensions vary between sexes. Men typically have broader shoulders and women a wider pelvis. Whether gender-affirming hormone therapy (GAHT) with or without prior puberty suppression (PS) alters these dimensions in transgender individuals remains unclear.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To investigate impact of PS and GAHT on skeletal dimensions.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This retrospective cross-sectional study, conducted at a gender identity clinic, included transgender individuals assigned male at birth (AMAB) and assigned female at birth (AFAB) who underwent dual-energy x-ray absorptiometry (DXA) scanning between ages 18 and 28 years and who were divided into 4 groups: Early PS (Tanner G\/B2-3) + GAHT, Late PS (Tanner G\/B4-5) + GAHT, GAHT-only, and untreated. Shoulder and pelvis dimensions measured by DXA were compared between groups, with adjustment for height.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A total of 121 individuals AMAB and 122 AFAB were included. Only individuals AMAB who underwent early PS had smaller shoulders compared to untreated individuals AMAB (\u22121.3\u2005cm; 95% CI \u22122.1; \u22120.5). In individuals AMAB from both the Early and Late PS groups, pelvic inlet, pubic symphysis width, and interischial distance were greater compared to untreated individuals AMAB, resulting in dimensions comparable to untreated individuals AFAB. Only in Early PS AFAB was pelvic inlet width smaller compared to untreated individuals AFAB (\u22121.0\u2005cm; 95% CI \u22121.5; \u22120.6), and comparable to untreated individuals AMAB.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>The study results suggest that skeletal dimensions are only altered by GAHT if endogenous puberty has not yet been completed at start of PS. These findings enhance our understanding of hormonal effects on the skeleton and may hold clinical relevance for body image as well as for forensic anthropology. Future research should evaluate clinical implications for surgical or obstetrical outcomes in transgender individuals.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1210\/clinem\/dgae574","type":"journal-article","created":{"date-parts":[[2024,8,15]],"date-time":"2024-08-15T14:38:14Z","timestamp":1723732694000},"page":"e1411-e1419","source":"Crossref","is-referenced-by-count":10,"title":["Shaping the Skeleton: Impact of GnRH Analogue and Sex Hormone Therapy on Skeletal Dimensions in Transgender Individuals"],"prefix":"10.1210","volume":"110","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 UMC location Vrije Universiteit , 1081 HV Amsterdam ,","place":["The Netherlands"]},{"name":"Amsterdam Gastroenterology Endocrinology Metabolism , 1081 HV Amsterdam ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Boukje Teatske","family":"Sikma","sequence":"additional","affiliation":[{"name":"Center of Expertise on Gender Dysphoria, Amsterdam UMC location Vrije Universiteit , 1081 HV Amsterdam ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4245-783X","authenticated-orcid":false,"given":"Mark-Bram","family":"Bouman","sequence":"additional","affiliation":[{"name":"Center of Expertise on Gender Dysphoria, Amsterdam UMC location Vrije Universiteit , 1081 HV Amsterdam ,","place":["The Netherlands"]},{"name":"Department of Plastic Reconstructive and Hand Surgery, Amsterdam University Medical Center location VUMC , 1081 HV Amsterdam ,","place":["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":"Amsterdam Gastroenterology Endocrinology Metabolism , 1081 HV Amsterdam ,","place":["The Netherlands"]},{"name":"Department of Pediatric Endocrinology, Amsterdam University Medical Center location AMC , 1105 AZ Amsterdam ,","place":["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 UMC location Vrije Universiteit , 1081 HV Amsterdam ,","place":["The Netherlands"]},{"name":"Amsterdam Gastroenterology Endocrinology Metabolism , 1081 HV Amsterdam ,","place":["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 UMC location Vrije Universiteit , 1081 HV Amsterdam ,","place":["The Netherlands"]},{"name":"Amsterdam Gastroenterology Endocrinology Metabolism , 1081 HV Amsterdam ,","place":["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 UMC location Vrije Universiteit , 1081 HV Amsterdam ,","place":["The Netherlands"]},{"name":"Amsterdam Gastroenterology Endocrinology Metabolism , 1081 HV Amsterdam ,","place":["The Netherlands"]},{"name":"Department of Pediatric Endocrinology, Amsterdam University Medical Center location AMC , 1105 AZ Amsterdam ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","published-online":{"date-parts":[[2024,8,16]]},"reference":[{"issue":"Suppl 1","key":"2025042208280707700_dgae574-B1","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":"11","key":"2025042208280707700_dgae574-B2","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":"2","key":"2025042208280707700_dgae574-B3","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":"2025042208280707700_dgae574-B4","doi-asserted-by":"crossref","first-page":"e782","DOI":"10.1210\/clinem\/dgaa841","article-title":"Sustained breast development and breast anthropometric changes in 3 years of gender-affirming hormone treatment","volume":"106","author":"de Blok","year":"2021","journal-title":"J Clin Endocrinol Metab"},{"issue":"10","key":"2025042208280707700_dgae574-B5","doi-asserted-by":"crossref","first-page":"1117","DOI":"10.1093\/ced\/llad203","article-title":"The effect of gender-affirming hormone therapy on hair growth: a systematic review of the literature","volume":"48","author":"Tang","year":"2023","journal-title":"Clin Exp Dermatol"},{"issue":"9","key":"2025042208280707700_dgae574-B6","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":"2","key":"2025042208280707700_dgae574-B7","doi-asserted-by":"crossref","first-page":"414","DOI":"10.1210\/clinem\/dgac571","article-title":"Just as tall on testosterone; a neutral to positive effect on adult height of GnRHa and testosterone in trans boys","volume":"108","author":"Willemsen","year":"2023","journal-title":"J Clin Endocrinol Metab"},{"issue":"19","key":"2025042208280707700_dgae574-B8","doi-asserted-by":"crossref","first-page":"5227","DOI":"10.1073\/pnas.1517085113","article-title":"Developmental evidence for obstetric adaptation of the human female pelvis","volume":"113","author":"Huseynov","year":"2016","journal-title":"Proc Natl Acad Sci U S A"},{"issue":"2","key":"2025042208280707700_dgae574-B9","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1127\/anthranz\/2020\/1005","article-title":"Dimorphic differences in selected somatic parameters in students of equal height","volume":"77","author":"Tatarczuk","year":"2020","journal-title":"Anthropol Anz"},{"issue":"3","key":"2025042208280707700_dgae574-B10","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1359\/JBMR.041005","article-title":"Males have larger skeletal size and bone mass than females, despite comparable body size","volume":"20","author":"Nieves","year":"2005","journal-title":"J Bone Miner Res"},{"key":"2025042208280707700_dgae574-B11","doi-asserted-by":"crossref","first-page":"165.e1","DOI":"10.1016\/j.forsciint.2016.02.007","article-title":"A review of sex estimation techniques during examination of skeletal remains in forensic anthropology casework","volume":"261","author":"Krishan","year":"2016","journal-title":"Forensic Sci Int"},{"issue":"5","key":"2025042208280707700_dgae574-B12","doi-asserted-by":"crossref","first-page":"1303","DOI":"10.1007\/s10508-012-9989-4","article-title":"Biometric characteristics of the pelvis in female-to-male transsexuals","volume":"41","author":"Sitek","year":"2012","journal-title":"Arch Sex Behav"},{"issue":"4","key":"2025042208280707700_dgae574-B13","doi-asserted-by":"crossref","first-page":"773","DOI":"10.1016\/j.bone.2010.07.007","article-title":"Bone and body segment lengthening and widening: a 7-year follow-up study in pubertal girls","volume":"47","author":"V\u00f6lgyi","year":"2010","journal-title":"Bone"},{"issue":"2","key":"2025042208280707700_dgae574-B14","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1127\/homo\/2020\/1116","article-title":"Stature estimation formulae based on bony pelvic dimensions and femoral length","volume":"71","author":"Imai","year":"2020","journal-title":"Homo"},{"issue":"2","key":"2025042208280707700_dgae574-B15","first-page":"419","article-title":"Gender-specific growth patterns of transversal body dimensions in Croatian children and youth (2 to 18 years of age)","volume":"32","author":"Zivicnjak","year":"2008","journal-title":"Coll Antropol"},{"issue":"5","key":"2025042208280707700_dgae574-B16","doi-asserted-by":"crossref","first-page":"931","DOI":"10.1002\/jbmr.4262","article-title":"Development of hip bone geometry during gender-affirming hormone therapy in transgender adolescents resembles that of the experienced gender when pubertal suspension is started in early puberty","volume":"36","author":"van der Loos","year":"2021","journal-title":"J Bone Miner Res"},{"issue":"1","key":"2025042208280707700_dgae574-B17","doi-asserted-by":"crossref","first-page":"949","DOI":"10.1186\/s12884-022-05290-x","article-title":"Magnetic resonance imaging in late pregnancy to improve labour and delivery outcomes\u2014a systematic literature review","volume":"22","author":"Jaufuraully","year":"2022","journal-title":"BMC Pregnancy Childbirth"},{"issue":"4","key":"2025042208280707700_dgae574-B18","doi-asserted-by":"crossref","first-page":"634e","DOI":"10.1097\/PRS.0000000000007779","article-title":"Vaginal canal reconstruction in penile inversion vaginoplasty with flaps, peritoneum, or skin grafts: where is the evidence?","volume":"147","author":"Salibian","year":"2021","journal-title":"Plast Reconstr Surg"},{"issue":"4","key":"2025042208280707700_dgae574-B19","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\u20132015): trends in prevalence, treatment, and regrets","volume":"15","author":"Wiepjes","year":"2018","journal-title":"J Sex Med"},{"key":"2025042208280707700_dgae574-B20","volume-title":"Diagnostic and Statistical Manual of Mental Disorders","year":"2018","edition":"5th ed"},{"key":"2025042208280707700_dgae574-B21","volume-title":"Diagnostic and Statistical Manual of Mental disorders","year":"2000","edition":"4th ed"},{"issue":"3","key":"2025042208280707700_dgae574-B22","doi-asserted-by":"crossref","first-page":"317","DOI":"10.21037\/cdt.2017.03.12","article-title":"Assessing observer variability: a user's guide","volume":"7","author":"Popovi\u0107","year":"2017","journal-title":"Cardiovasc Diagn Ther"},{"issue":"12","key":"2025042208280707700_dgae574-B23","doi-asserted-by":"crossref","first-page":"1332","DOI":"10.1001\/jamapediatrics.2023.4588","article-title":"Bone mineral density in transgender adolescents treated with puberty suppression and subsequent gender-affirming hormones","volume":"177","author":"van der Loos","year":"2023","journal-title":"JAMA Pediatr"},{"key":"2025042208280707700_dgae574-B24","unstructured":"Boogers LS, Sikma BT, Bouman M, et al 2024. Supplemental figure 1. Bland Altman plots of interobserver differences for skeletal dimensions. figshare. 10.6084\/m9.figshare.26538721.v2."},{"key":"2025042208280707700_dgae574-B25","unstructured":"Boogers LS, Sikma BT, Bouman M, et al 2024. Supplemental table 1. Comparisons of skeletal dimensions between different groups with coefficient and 95% confidence interval. figshare. 10.6084\/m9.figshare.26538760.v1."},{"issue":"7","key":"2025042208280707700_dgae574-B26","doi-asserted-by":"crossref","first-page":"612","DOI":"10.1136\/adc.2005.085522","article-title":"Measuring body composition","volume":"91","author":"Wells","year":"2006","journal-title":"Arch Dis Child"},{"issue":"8","key":"2025042208280707700_dgae574-B27","doi-asserted-by":"crossref","first-page":"e23753","DOI":"10.1002\/ajhb.23753","article-title":"Evaluation of dual-energy X-ray absorptiometry compared to magnetic resonance imaging for collecting measurements of the human bony pelvis","volume":"34","author":"Decrausaz","year":"2022","journal-title":"Am J Hum Biol"},{"key":"2025042208280707700_dgae574-B28","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/BF02447636","article-title":"Sexual dimorphism in growth from 8 to 18 years","volume":"8","author":"Medved","year":"1993","journal-title":"Int J Anthropol"},{"issue":"3","key":"2025042208280707700_dgae574-B29","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1002\/ar.1091720312","article-title":"The development of sexual dimorphism in the bony pelvis of the squirrel monkey","volume":"172","author":"Gingerich","year":"1972","journal-title":"Anat Rec"},{"issue":"2","key":"2025042208280707700_dgae574-B30","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1055\/s-0042-1749099","article-title":"Gender affirming body contouring and physical transformation in transgender individuals","volume":"55","author":"Asokan","year":"2022","journal-title":"Indian J Plast Surg"},{"issue":"2","key":"2025042208280707700_dgae574-B31","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1111\/1471-0528.15438","article-title":"Uterine transplantation in transgender women","volume":"126","author":"Jones","year":"2019","journal-title":"Bjog"},{"issue":"2\u20133","key":"2025042208280707700_dgae574-B32","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1016\/j.forsciint.2004.09.111","article-title":"The reliability of sex determination of skeletons from forensic context in the Balkans","volume":"147","author":"Duri\u0107","year":"2005","journal-title":"Forensic Sci Int"},{"issue":"4","key":"2025042208280707700_dgae574-B33","first-page":"524","article-title":"How do drugs affect the Skeleton? Implications for Forensic Anthropology","volume":"11","author":"M\u00e1rquez-Grant","year":"2022","journal-title":"Biology (Basel)"},{"issue":"8","key":"2025042208280707700_dgae574-B34","doi-asserted-by":"crossref","first-page":"1019","DOI":"10.1007\/s00192-011-1416-1","article-title":"The relationship between anthropometric measurements and the bony pelvis in African American and European American women","volume":"22","author":"Ridgeway","year":"2011","journal-title":"Int Urogynecol J"}],"container-title":["The Journal of Clinical Endocrinology &amp; Metabolism"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jcem\/advance-article-pdf\/doi\/10.1210\/clinem\/dgae574\/58996422\/dgae574.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jcem\/article-pdf\/110\/5\/e1411\/58996422\/dgae574.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jcem\/article-pdf\/110\/5\/e1411\/58996422\/dgae574.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,22]],"date-time":"2025-04-22T12:28:46Z","timestamp":1745324926000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jcem\/article\/110\/5\/e1411\/7734697"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,16]]},"references-count":34,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2024,8,16]]},"published-print":{"date-parts":[[2025,4,22]]}},"URL":"https:\/\/doi.org\/10.1210\/clinem\/dgae574","relation":{},"ISSN":["0021-972X","1945-7197"],"issn-type":[{"value":"0021-972X","type":"print"},{"value":"1945-7197","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,5]]},"published":{"date-parts":[[2024,8,16]]}}}