Impact of Gonadotropin-releasing Hormone Analogue and Gender-affirming Hormone Therapy on Bone Mineral Density in Transgender Adolescents

Background: Sex hormones have a key impact on the development of the human body during puberty, including a significant influence on bone development - their shape, structure, length, and mineral density. Due to the growing number of transgender and gender diverse (TGD) adolescents and the increasing demand for gender-affirming hormone therapy (GAHT), there is rising curiosity about the impact of this therapy on the developing body of a young person. Purpose: This review aims to summarize the latest scientific reports on the impact of gonadotropin-releasing hormone analogues (GnRHas) and GAHT on the bone mineral density (BMD) of transgender adolescents undergoing gender-changing therapies. Findings: Low pretreatment BMD is more common among TGD adolescents than in the general population, and this is more prevalent in transgirls than in transboys. BMD Z-scores decline during treatment with GnRHas and respond differentially to GAHT. Regular follow-up and health advice are essential. Further long-term studies of the effects of these therapies on peak bone mass and future fracture risk are needed.