@article{3087563,
  abstract     = {Context: Female-to-male transsexual persons (transsexual men) undergo extreme hormonal changes due to ovariectomy and testosterone substitution, allowing studies on sex steroid effects on bone geometry and physiology in the adult. 
Objective: The objective of the study was to examine the effects of cross-gender sex steroid exposure on volumetric bone parameters in transsexual men. 
Design: This was a cross-sectional study. 
Setting: Participants were recruited from the Center for Sexology and Gender Problems at the Ghent University Hospital (Ghent, Belgium). 
Participants: Fifty transsexual men after sex reassignment surgery with 50 age-matched control women and an additional 16 transsexual men before testosterone substitution and sex reassignment surgery with 16 control women participated in the study. 
Main Outcome Measures: The main outcome measures were areal and volumetric bone parameters using dual-energy X-ray absorptiometry and peripheral quantitative computed tomography, body composition (dual-energy X-ray absorptiometry), sex steroids, markers of bone turnover and grip strength. 
Results: Before hormonal treatment, transsexual men had similar body composition and bone geometry as female controls. The transsexual men on long-term testosterone therapy, however, demonstrated a higher lean body mass and muscle mass and a greater grip strength as well as a lower body and subcutaneous fat mass and a larger waist and smaller hip circumference compared with female controls (all P < 0.001). We observed a larger radial cortical bone size (P < 0.001) and lower cortical volumetric bone mineral density at the radius and tibia (P < 0.05) in transsexual men on testosterone therapy. 
Conclusions: Transsexual men on testosterone substitution therapy present with a different body composition with more muscle mass and strength and less fat mass as well as an altered bone geometry with larger bones compared with female controls.},
  author       = {Van Caenegem, Eva and Wierckx, Katrien and Taes, Youri and Dedecker, David and Van de Peer, Fleur and Toye, Kaatje and Kaufman, Jean and T'Sjoen, Guy},
  issn         = {0021-972X},
  journal      = {JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM},
  keywords     = {QUANTITATIVE COMPUTED-TOMOGRAPHY,MINERAL DENSITY,FAT DISTRIBUTION,POSTMENOPAUSAL WOMEN,PHYSICAL-ACTIVITY,TENNIS PLAYERS,SIZE,AGE,TESTOSTERONE,MEN},
  language     = {eng},
  number       = {7},
  pages        = {2503--2511},
  title        = {Bone mass, bone geometry, and body composition in female-to-male transsexual persons after long-term cross-sex hormonal therapy},
  url          = {http://dx.doi.org/10.1210/jc.2012-1187},
  volume       = {97},
  year         = {2012},
}

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