Bone mineral density, trabecular bone score and muscle strength in transgender men receiving testosterone therapy versus cisgender men

Steroids. 2022 Feb:178:108951. doi: 10.1016/j.steroids.2021.108951. Epub 2021 Dec 23.

Abstract

Introduction: Data on body composition, bone mineral density (BMD) and microarchitecture between cis and trans men are scarce. Few studies have reported trabecular bone score (TBS) data for transgender men using testosterone.

Experimental: We studied 19 transgender men and 19 cisgender men (mean age 23.6 ± 3.4 years, p = 0.539) paired by age and body mass index (BMI). They underwent clinical and hormonal evaluation, body composition measurement, and evaluation BMD, the TBS, grip strength, the level of physical activity (IPAQ) and physical performance (SPPB).

Results: Median serum testosterone levels were similar between the cisgender and transgender groups (638 vs. 685 ng/dl; p = 0.863). Mean serum estradiol levels were slightly higher in the transgender men (51.95 ± 44.26 vs. 32.26 ± 8.40 pg/ml, p = 0.005), and the median testosterone use duration in the transgender group was 24 months. Total muscle mass (44.09 ± 6.27 vs. 55.71 ± 7.28 kg, p < 0.001), and hand grip strength (28.82 ± 5.42 vs. 40.34 ± 8.03 kg, p < 0.001) were considerably lower in the transgender men. Total body BMD (1.208 ± 0.132 vs. 1.271 ± 0.081 g/cm2, p = 0.008) and femoral neck BMD (1.019 ± 0.163 vs. 1.137 ± 0.166 g/cm2, p = 0.016) were lower in the transgender group. The TBS was similar between groups. Thus, our data demonstrated that despite similar serum testosterone levels, transgender men undergoing testosterone therapy had lower muscle strength, muscle mass, and total body and femoral neck BMD values than cisgender men.

Keywords: Body composition; Grip strength; IPAQ; SPPB; TBS; Transgender men.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Bone Density*
  • Cancellous Bone
  • Hand Strength
  • Humans
  • Male
  • Muscle Strength / physiology
  • Testosterone
  • Transgender Persons*
  • Young Adult

Substances

  • Testosterone