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Journal of Pediatric Endocrinology and Metabolism

Editor-in-Chief: Kiess, Wieland

Ed. by Bereket, Abdullah / Darendeliler, Feyza / Dattani, Mehul / Gustafsson, Jan / Luo, Fei Hong / Toppari, Jorma / Turan, Serap Demircioglu


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2191-0251
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Volume 33, Issue 1

Issues

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

Rahul Ghelani
  • Department of Paediatric and Adolescent Endocrinology, University College London Hospital, London, UK
  • Other articles by this author:
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/ Cheryl Lim
  • Department of Paediatric and Adolescent Endocrinology, University College London Hospital, London, UK
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Caroline Brain
  • Department of Paediatric and Adolescent Endocrinology, University College London Hospital, London, UK
  • Other articles by this author:
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/ Mary Fewtrell / Gary ButlerORCID iD: https://orcid.org/0000-0002-7094-1581
  • Corresponding author
  • Department of Paediatric and Adolescent Endocrinology, University College London Hospital, London, UK
  • UCL Great Ormond Street Institute of Child Health, London, UK
  • Department of Paediatrics, University College London Hospital, 250 Euston Road, London NW1 2PQ, UK
  • Gender Identity Development Service, Tavistock and Portman NHS Trust, Leeds, UK
  • orcid.org/0000-0002-7094-1581
  • Email
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
Published Online: 2019-12-13 | DOI: https://doi.org/10.1515/jpem-2019-0045

Abstract

Background

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?

Methods

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.

Keywords: BMI; body composition; gender dysphoria; GnRHa treatment; sex hormones

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About the article

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.


Received: 2019-01-22

Accepted: 2019-10-01

Published Online: 2019-12-13

Published in Print: 2020-01-28


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

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

Employment or leadership: None declared.

Honorarium: None declared.

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

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


Citation Information: Journal of Pediatric Endocrinology and Metabolism, Volume 33, Issue 1, Pages 107–112, ISSN (Online) 2191-0251, ISSN (Print) 0334-018X, DOI: https://doi.org/10.1515/jpem-2019-0045.

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