Thread From an Endocrinologist on Bone Health and Hormone Blockers Study
SOCIAL MEDIA
Endocrinologist William Malone circulated commentary on his Twitter account relevant to a study referenced on the GHQ website in our section about the medical consequences to youth treated for gender dysphoria. The study he references is Joseph et al., 2018, “The effect of GnRHa treatment on bone density in young adolescents with gender dysphoria: findings from a large national cohort.”
The tone of the bone density study is positive:
We have shown that there is no actual change in BMAD or tBMD in young transgender adolescents on long term GnRHa therapy, and certainly no true fall as initially suspected.
Dr Malone is the second doctor cited on this website who believes the way this study is framed is biased. The commentary from the other doctor, endocrinologist Micheal Laidlaw, can be found in our section about pro transition attitudes among health professionals that possibly cause bias.
The thread touches on the importance of bone growth during adolescence and his criticism of the researchers allegedly trying to redefine bone health criteria. In the thread “PB” means puberty blockers, which have a multitude of possible effects:
@will_malone, endocrinologist
Here is a quote from the original study where the researchers say the criteria for what is considered normal bone growth should be changed for dysphoric minors on hormone blocker to a new, lower standard:
“We also suggest that reference ranges may need to be re-defined for this patient cohort.”
Transitioning as a fully formed adult may be safer for bone health, as this study did not yield alarming results.
REFERENCES:
Exercise, Nutrition, Hormones, and Bone Tissue. Rice University. Retrieved from https://opentextbc.ca/anatomyandphysiology/chapter/6-6-exercise-nutrition-hormones-and-bone-tissue/
Biggs, M. (2018). Bone density graph based on Joseph et al. (2018)
Fighera, T. M., Ziegelmann, P. K., Silva, T. R., Spritzer, P. M. (2019). Bone Mass Effects of Cross-Sex Hormone Therapy in Transgender People: Updated Systematic Review and Meta-Analysis. J Endocr Soc. 3(5): 943–964. doi: 10.1210/js.2018-00413
Joseph, T., Ting, J., & Butler, G. (2018). The effect of GnRHa treatment on bone density in young adolescents with gender dysphoria: Findings from a large national cohort. Endocrine Abstracts. doi:10.1530/endoabs.58.oc8.2
Moyle, S. D. (2009). Low Bone Density and Osteoporosis in Children. HSS. Retrieved from https://www.hss.edu/conditions_low-bone-density-osteoporosis-children.asp