@article{8607211,
  abstract     = {{Context: Progestins can be used to attenuate endogenous hormonal effects in late-pubertal transgender (trans) adolescents (Tanner stage B4/5 and G4/5). Currently, no data are available on the effects of progestins on the development of bone mass or body composition in trans youth. 
Objective: To study prospectively the evolution of body composition and bone mass in late-pubertal trans adolescents using the proandrogenic or antiandrogenic progestins lynestrenol (L) and cyproterone acetate (CA), respectively. 
Design and Outcome Measurements: Forty-four trans boys (Tanner B4/5) and 21 trans girls (Tanner G4/5) were treated with L or CA for 11.6 (4 to 40) and 10.6 (5 to 31) months, respectively. Anthropometry, grip strength, body composition, and bone mass, size, and density were determined by dual-energy X-ray absorptiometry and peripheral quantitative computed tomography before the start of progestin and before addition of cross-sex hormones. 
Results: Using L, lean mass [+3.2 kg (8.6%)] and grip strength [+3 kg (10.6%)] significantly increased, which coincided with a more masculine body shape in trans boys. Trans girls showed loss of lean mass [-2.2 kg (4.7%)], gain of fat mass [+1.5 kg (9.4%)], and decreased grip strength Z scores. CA limited normal bone expansion and impeded pubertal bone mass accrual, mostly at the lumbar spine [Z score: -0.765 to -1.145 (P = 0.002)]. L did not affect physiological bone development. 
Conclusion: Proandrogenic and antiandrogenic progestins induce body composition changes in line with the desired appearance within 1 year of treatment. Bone health, especially at the lumbar spine, is of concern in trans girls, as bone mass accrual is severely affected by androgen suppressive therapy.}},
  author       = {{Tack, Lloyd and Craen, Margarita and Lapauw, Bruno and Goemaere, Stefan and Toye, Kaatje and Kaufman, Jean and VANDEWALLE, SARA and T'Sjoen, Guy and Zmierczak, Hans-Georg and Cools, Martine}},
  issn         = {{0021-972X}},
  journal      = {{JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM}},
  keywords     = {{SEX HORMONE-TREATMENT,DEPOT MEDROXYPROGESTERONE ACETATE,QUANTITATIVE COMPUTED-TOMOGRAPHY,LONG-TERM USERS,MINERAL DENSITY,TRANSSEXUAL PERSONS,FEMALE ADOLESCENTS,ONLY CONTRACEPTION,CLINICAL-PRACTICE,FREE TESTOSTERONE}},
  language     = {{eng}},
  number       = {{6}},
  pages        = {{2147--2156}},
  title        = {{Proandrogenic and antiandrogenic progestins in transgender youth : differential effects on body composition and bone metabolism}},
  url          = {{http://dx.doi.org/10.1210/jc.2017-02316}},
  volume       = {{103}},
  year         = {{2018}},
}

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