IMPE Abstracts

Background: Transgender and gender-diverse (TGD) individuals are exposed to many factors which have the potential to affect their bone mineral density (BMD). Among these factors are eating habits, exercise, calcium and vitamin D intake. Moreover, as these individuals are children and adolescents, who have not accomplished peak bone mass (PBM) yet. This fact raises the question of whether TGD youth should have routine bone health assessment.

Aim: To provide data regarding determinant factors that may affect PBM in TGD youth, their BMD and corporal composition before gender-diverse intervention.

Materials and methods: Cross-sectional multicenter study including 84 TGD youth who attended 3 centers in Buenos Aires, Argentina. Eating habits, exercise and sport survey was conducted. Laboratory data: phosphocalcic and gonadotropin profile were obtained. Body composition and BMD at Lumbar Spine (LS) by DXA (Lunar Prodigy Advance) were assessed.

Results: 84 TGD youth, 64 Transmale (TM) and 20 Transfemale (TF), were included. Mean Age was 15.29 years (range 9-18). 50% of individuals did not practice sports or recreational physical activities. 21% of TM and 30% of TF referred to have vegetarian or ovo-lacto-vegetarian eating habits. Mean 25 hydroxyvitamin D value was 19.5 ± 9,95 ng/ml, without differences between both groups. 35% of the whole group has 25 hydroxivitamin D between 19 and 30 ng/ml, 45 % < 20 ng/ml and 20% has vitamin D < 10 ng/ml. Mean BMD at LS (g/cm2) for TM was 1,11 ± 0,17 and 1,07 ± 0,17 for TF with no significant difference among genders. Mean Z score BMD at LS was -0.03 ± 1 for TM and -0.56 ± 0.6 for TF. Mean Basal CMO was significantly different among genders: TM 1555,81 ± 324,23 vs TF 1885,11± 429,74 (P<0.05). Mean lean mass (30,64 ±6,32 in TM vs 39,87 ±7,57 in TF) and mean fat mass (32,4% inTM vs 38,8% in TF) were significantly different among genders (P<0.05).

Conclusion: We observed a large proportion of 25 hydroxivitamin D deficiency, vegetarian or ovo-lacto-vegetarian eating habits, in addition to sedentary lifestyle. As it was previously described, TF had BMD z score lower than TM. These findings support the fact that a comprehensive basal assessment of bone health is essential and clinicians should consider monitoring BMD among TGD youth, a group at potential risk for poor bone health.