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Liverpool, UK – New research has uncovered how hormone therapy, when paired with puberty blockers during adolescence, can alter skeletal proportions, offering critical insights for transgender individuals undergoing gender-affirming treatments. The findings were presented at the European Society for Paediatric Endocrinology Meeting by researchers from Amsterdam University Medical Center (UMC) in the Netherlands.
The study highlights the significant role of sex hormones in shaping skeletal dimensions, such as the shoulders and pelvis, and could help improve counselling on the physical impacts of gender-affirming treatments.
Gender-affirming hormones are used to align an individual’s physical characteristics with their gender identity. For transgender youth, puberty blockers can delay or prevent the physical changes associated with puberty, providing time to explore their identity before permanent changes occur. However, the extent to which these treatments affect skeletal proportions has remained unclear.
To address this, researchers analyzed data from 243 transgender individuals—121 transgender women and 122 transgender men—who were undergoing hormone therapy, with or without prior puberty blockers, or who had not received any treatment.
The study found notable differences in skeletal proportions depending on the timing of treatment:
- Transgender men treated with puberty blockers from early puberty followed by hormone therapy developed broader shoulders and a smaller pelvic inlet compared to untreated individuals.
- Transgender women treated early had smaller shoulders and a larger pelvis, with these changes being most pronounced in those who started blocking puberty earlier.
“This is the first study to explore the effect of both gender-affirming hormones and puberty blockers on pelvic dimensions,” said lead researcher Lidewij Boogers, a PhD student at Amsterdam UMC. “Our findings suggest that irreversible skeletal changes occur during puberty, emphasizing the importance of early intervention for individuals seeking to align their physical characteristics with their affirmed gender.”
The study sheds light on how critical puberty is for skeletal development, as skeletal proportions in individuals who began puberty suppression early were most similar to those of their affirmed gender.
Next, the researchers aim to explore how these physical changes impact body image and quality of life in transgender adolescents, paving the way for more tailored and supportive care.
The findings underscore the evolving understanding of the complex interactions between hormones, skeletal development, and gender-affirming healthcare, contributing valuable knowledge to the field of transgender medicine.
