{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T08:19:14Z","timestamp":1780474754205,"version":"3.54.1"},"reference-count":32,"publisher":"MDPI AG","issue":"22","license":[{"start":{"date-parts":[[2023,11,13]],"date-time":"2023-11-13T00:00:00Z","timestamp":1699833600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Health Studies Fund, Department of Family and Preventive Medicine, University of Utah Spencer Fox Eccles School of Medicine"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Previous research has shown a discrepancy in incidences of knee injuries, stress fractures, and concussions between cisgender men and women. Little is known regarding the incidence of musculoskeletal injuries among patients on gender-affirming hormone therapy (GAHT). This retrospective cohort study examines cumulative incidence of knee injuries, concussions, and stress fracture injuries among transgender patients on GAHT at one health system from 2011\u20132020. Using relevant ICD-9 and 10 codes, incidences of knee injury, concussion, and stress fracture were calculated. Cohorts included 1971 transgender and 3964 cisgender patients. Transgender patients had significantly higher incidence of all-cause knee injuries over the study period, 109 (5.5%) versus 175 (4.4%) (p &lt; 0.001; OR: 2.14, 95% CI [1.17\u20133.92]). Subgroup analysis showed significantly higher incidence of knee injuries among cisgender men (5.6%) versus cisgender women (4.1%) (p = 0.042) and among transgender women (6.6%) versus cisgender women (4.1%) (p = 0.005). There were no significant differences between incidences of concussion and stress fracture between groups. This sample showed that patients on GAHT had increased cumulative incidences of all-cause knee injury compared to controls but similar cumulative incidences of concussion and bone-stress injuries. Transgender women on exogenous estrogen had significantly higher cumulative incidences of all-cause knee injuries compared to cisgender women.<\/jats:p>","DOI":"10.3390\/ijerph20227060","type":"journal-article","created":{"date-parts":[[2023,11,14]],"date-time":"2023-11-14T02:20:37Z","timestamp":1699928437000},"page":"7060","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Cumulative Incidence of All-Cause Knee Injury, Concussion, and Stress Fracture among Transgender Patients on Gender-Affirming Hormone Therapy: An Exploratory Retrospective Cohort Study"],"prefix":"10.3390","volume":"20","author":[{"given":"Emily W.","family":"Miro","sequence":"first","affiliation":[{"name":"Division of Family Medicine, Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT 84108, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-1733-5808","authenticated-orcid":false,"given":"Eliza","family":"Taylor","sequence":"additional","affiliation":[{"name":"Division of Family Medicine, Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT 84108, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Curtin","sequence":"additional","affiliation":[{"name":"Division of Family Medicine, Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT 84108, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael G.","family":"Newman","sequence":"additional","affiliation":[{"name":"Division of Family Medicine, Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT 84108, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5079-2152","authenticated-orcid":false,"given":"Dominik","family":"Ose","sequence":"additional","affiliation":[{"name":"Division of Family Medicine, Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT 84108, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-9732-941X","authenticated-orcid":false,"given":"Jordan","family":"Knox","sequence":"additional","affiliation":[{"name":"Division of Family Medicine, Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT 84108, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,11,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1","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. 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