Following The Links (Part 2)

Many times when I read something on the internet I research related topics that is what brought me to this web-page, this time on a forum where “Orange is the new Black” episode 3 was being discussed. In that episode Sophia Burset hormones are stopped by the prison staff and someone mentioned that stopping hormones wouldn’t kill you. I mentioned that you could lose bone density but before I wrote that I researched it on Pub Med database and found some interesting studies…

Body composition, volumetric and areal bone parameters in male-to-female transsexual persons.

CONCLUSION:
M-->F transsexual persons have less lean mass and muscle strength, and higher fat mass. In addition, they present lower trabecular vBMD and aBMD at the lumbar spine, total hip and distal radius, and smaller cortical bone size as compared to matched controls. Both the lower level of sports-related physical activity as well testosterone deprivation could contribute to these findings. These results indicate that bone health should be a parameter of interest in the long-term follow-up care for M-->F transsexual persons.

And another study,

Prevalence of low bone mass in relation to estrogen treatment and body composition in male-to-female transsexual persons.

Abstract
Bone health is a parameter of interest in the daily follow-up of male-to-female (M --> F) transsexual persons both before and after sex reassignment surgery (SRS) due to an intensely changing hormonal milieu. We have studied body composition, areal, geometric, and volumetric bone parameters, using DXA and peripheral quantitative computed tomography at different sites in 50 M --> F transsexual persons, at least 3 yr after the start of the hormonal treatment and 1 yr after SRS. In this cross-sectional study, hormone levels and markers of bone metabolism were assessed using immunoassays. Prevalence of low bone mass as defined by a Z-score < or = -2.0 according to DXA criteria was 26% at lumbar spine and 2% at the total hip. We found no major differences in hormonal parameters between participants with a Z-score < or = or > -2.0. Markers of bone turnover were comparable between subjects with or without low bone mass, indicating a stable bone turnover at the time of investigation. No significant differences in bone size or density were observed between patients on transdermal vs. oral estrogens. Low bone mass is not uncommon in M --> F transsexual persons. Smaller bone size, and a strikingly lower muscle mass compared with men appear to underlie these findings.

It seems that one of the things that we have to be aware of when we are on cross gender hormones is our bone density. I had a bone density scan this spring after 9 years on hormones, my bone density was normal.

And I also came across this interesting webpage at University of California, San Francisco, Center of Excellence for Transgender Health website where the recommend healthcare for trans-patients (Primary Care Protocol for Transgender Patient Care). Well worth reading.