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Licensed Unlicensed Requires Authentication Published by De Gruyter December 13, 2019

Sudden sex hormone withdrawal and the effects on body composition in late pubertal adolescents with gender dysphoria

  • Rahul Ghelani , Cheryl Lim , Caroline Brain , Mary Fewtrell and Gary Butler ORCID logo EMAIL logo



Sex hormones initiate profound physical and physiological changes during the pubertal process, but to what extent are they responsible for continuing the body composition changes of late adolescence and what happens to body composition on sudden sex hormone withdrawal?


Thirty-six healthy, phenotypically and chromosomally normal late and post-pubertal individuals aged 15–17 years with gender dysphoria (transgirls – birth-registered males identifying as female n = 11; and transboys – birth-registered females identifying as male n = 25) underwent Tanita body composition analysis at 0, 6 and 12 months during reproductive hormone suppression with Triptorelin as part of the standard therapeutic protocol.

Results and conclusions

In the transgirl cohort, paired t-test analysis demonstrated a significant decrease in height and lean mass standard deviation scores over the 12-month period, going against an expected trajectory over that time. In contrast, oestrogen suppression appeared not to affect the body composition of transboys; their measurements were not significantly different at baseline and after 12 months of treatment. The withdrawal of sex hormone secretion does not appear to have a significant impact on female post-pubertal body composition, in contrast to that seen at the menopause. This suggests that other factors may preserve normal body balance in adolescents in the absence of sex steroids.

Corresponding author: Prof. Gary Butler, Department of Paediatrics, University College London Hospital, 250 Euston Road, London NW1 2PQ, UK; Department of Paediatric and Adolescent Endocrinology, University College London Hospital, London, UK; UCL Great Ormond Street Institute of Child Health, London, UK; and Gender Identity Development Service, Tavistock and Portman NHS Trust, Leeds, UK, Phone: +44 (0)20 344 79455
aJoint first authors.


We thank the team members from the national Gender Identity Development Service; we also thank Kirpal Adu-Gyamfi and other outpatient staff members for performing the auxological assessments.

  1. Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

  2. Research funding: This project was conducted as part of a UCL Medical School academic programme.

  3. Employment or leadership: None declared.

  4. Honorarium: None declared.

  5. Competing interests: This research did not receive any specific grant from funding agencies in the public, commercial or not-for-profit sectors.

  6. Conflicts of interest: The authors declare that they have no conflict of interest.


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Received: 2019-01-22
Accepted: 2019-10-01
Published Online: 2019-12-13
Published in Print: 2020-01-28

©2020 Walter de Gruyter GmbH, Berlin/Boston

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