Body mass index and body composition changes in transgender people undergoing gender-affirming hormone therapy: a systematic review and meta-analysis

Deutsch MB. Guidelines for the Primary and Gender-Affirming Care of Transgender and Gender Nonbinary People. Department of Family & Community Medicine University of California, San Francisco 2nd Edition – Published June 17, 2016.

Hembree WC, Cohen-Kettenis PT, Gooren L, et al. Endocrine treatment of Gender-Dysphoric/Gender-Incongruent persons: an endocrine society clinical practice guideline. Clin Endocrinol Metab. 2018;103(7):2758–9.

Article  Google Scholar 

T’sjoen G, Arcelus J, Gooren L, Klink Dt TV. Endocrinology of transgender medicine. Endocr Rev. February 2019;40(1):97–117.

Zucker KJ. Epidemiology of gender dysphoria and transgender identity. Sex Health. 2017;14(5):404–11. https://doi.org/10.1071/SH17067.

Article  PubMed  Google Scholar 

Spanos C, Bretherton I, Zajac JD, Cheung AS. Effects of gender-affirming hormone therapy on insulin resistance and body composition in transgender individuals: A systematic review. World J Diabetes. 2020;11(3):66–77.

Article  PubMed  PubMed Central  Google Scholar 

Sebastião ML, e Accardo CL. Riscos cardiovasculares Em transgêneros: Revisão Da literatura. Revista Eletrônica Acervo Saúde/Electronic J Collect Health, 13(1), 2021.

Harper J, O’Donnell E, Sorouri Khorashad B, et al. How does hormone transition in transgender women change body composition, muscle strength and hemoglobin? This is a systematic review with a focus on the implications for sport participation. Br J Sports Med. 2021;55:865–72.

Article  PubMed  Google Scholar 

Velho I, et al. Effects of testosterone therapy on BMI, blood pressure, and laboratory profile of transgender men: a systematic review. Androl Vol. 2017;5(5):881–8. https://doi.org/10.1111/andr.12382.

Article  CAS  Google Scholar 

Klaver M, Dekker MJHJ, de Mutsert R, Twisk JWR, den Heijer M. Cross-sex hormone therapy in transgender persons affects total body weight, body fat and lean body mass: a meta-analysis. Andrologia. 2017;49(5). https://doi.org/10.1111/and.12660.

Page MJ, McKenzie JE, Bossuyt PM et al. Updating guidance for reporting systematic reviews: development of the PRISMA 2020 statement. J Clin Epidemiol. 2021;134:S0895-4356(21)00040– 8. https://doi.org/10.1016/j.jclinepi.2021.02.003

Sávio M, Gomes FB, Rodrigues, Ísis, Gois. Marcos Pereira-Santos. Cross-Sex Hormone Therapy in Transgender People and Overweight and Obesity: A systematic review and meta-analysis. PROSPERO 2022 CRD42022345902 Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022345902

Wells G, Shea B, O’Connell D. The Newcastle–Ottawa scale for assessing the quality of nonrandomized studies in meta-analyses. Ottawa Health Research Institute; 2012.

Giannì C, Prosperini L, Jonsdottir J, Cattaneo D. A systematic review of factors associated with accidental falls in people with multiple sclerosis: a meta-analytic approach. Clin Rehabil. 2014;28(7):704–16. https://doi.org/10.1177/0269215513517575.

Article  PubMed  Google Scholar 

Willis BH, Riley RD. Measuring the statistical validity of summary meta-analysis and meta-regression results for use in clinical practice. Stat Med. 2017;36:3283–301.

Article  PubMed  PubMed Central  Google Scholar 

Schünemann H, Brożek J, Guyatt G, Oxman A. GRADE handbook [Internet]. 2013 [cited 2025 Apr 28]. Available from: https://gdt.gradepro.org/app/handbook/handbook.html

Dekker MJ, Wierckx K, Van Caenegem E, Klaver M, Kreukels BP, Elaut E, Fisher AD, van Trotsenburg MA, Schreiner T, den Heijer M, T’Sjoen G. A European network for the investigation of gender incongruence: endocrine part. J Sex Med. 2016;13(6):994–9. https://doi.org/10.1016/j.jsxm.2016.03.371.

Article  CAS  PubMed  Google Scholar 

Auer MK, Ebert T, Pietzner M, Defreyne J, Fuss J, Stalla GK, Sjoen T, G. Effects of sex hormone treatment on the metabolic syndrome in transgender individuals: focus on metabolic cytokines. J Clin Endocrinol Metab. 2018;103(2):790–802. https://doi.org/10.1210/jc.2017-01559.

Article  PubMed  Google Scholar 

Deutsch MB, Bhakri V, Kubicek K. Effects of cross-sex hormone treatment on transgender women and men. Obstet Gynecol. 2015;125(3):605–10. https://doi.org/10.1097/AOG.0000000000000692.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Elbers JM, Asscheman H, Seidell JC, Gooren LJ. Effects of sex steroid hormones on regional fat depots as assessed by magnetic resonance imaging in transsexuals. Am J Physiol. 1999;276(2):E317–25. https://doi.org/10.1152/ajpendo.1999.276.2.E317.

Article  CAS  PubMed  Google Scholar 

Elbers JM, Giltay EJ, Teerlink T, Scheffer PG, Asscheman H, Seidell JC, Gooren LJ. Effects of sex steroids on components of the insulin resistance syndrome in transsexual subjects. Clin Endocrinol. 2003;58(5):562–71. https://doi.org/10.1046/j.1365-2265.2003.01753.x.

Article  CAS  Google Scholar 

Fernandez JD, Tannock LR. METABOLIC EFFECTS OF HORMONE THERAPY IN TRANSGENDER PATIENTS. Endocr Practice: Official J Am Coll Endocrinol Am Association Clin Endocrinologists. 2016;22(4):383–8. https://doi.org/10.4158/EP15950.OR.

Article  Google Scholar 

Kyinn M, Banks K, Leemaqz SY, Sarkodie E, Goldstein D, Irwig MS. (2021). Weight gain and obesity rates in transgender and gender-diverse adults before and during hormone therapy. International journal of obesity (2005), 45(12), 2562–2569. https://doi.org/10.1038/s41366-021-00935-x

Shadid S, Abosi-Appeadu K, De Maertelaere AS, Defreyne J, Veldeman L, Holst JJ, Lapauw B, Vilsbøll T, T’Sjoen G. Effects of Gender-Affirming hormone therapy on insulin sensitivity and incretin responses in transgender people. Diabetes Care. 2020;43(2):411–7. https://doi.org/10.2337/dc19-1061.

Article  CAS  PubMed  Google Scholar 

Van Caenegem E, Wierckx K, Taes Y, Schreiner T, Vandewalle S, Toye K, Kaufman JM, T’Sjoen G. Preservation of volumetric bone density and geometry in trans women during cross-sex hormonal therapy: a prospective observational study. Osteoporos International: J Established as Result Cooperation between Eur Foundation Osteoporos Natl Osteoporos Foundation USA. 2015;26(1):35–47. https://doi.org/10.1007/s00198-014-2805-3.

Article  CAS  Google Scholar 

Yun Y, Kim D, Lee ES. Effect of Cross-Sex hormones on body composition, bone mineral density, and muscle strength in trans women. J Bone Metab. 2021;28(1):59–66. https://doi.org/10.11005/jbm.2021.28.1.59.

Article  PubMed  PubMed Central  Google Scholar 

Fighera TM, da Silva E, Lindenau JD-R, Spritzer PM. Impact of cross-sex hormone therapy on bone mineral density and body composition in transwomen. Clin Endocrinol. 2018;88(6):856–62. https://doi.org/10.1111/cen.13607.

Article  CAS  Google Scholar 

Fisher AD, Castellini G, Ristori J, Casale H, Cassioli E, Sensi C, Fanni E, Amato AM, Bettini E, Mosconi M, Dèttore D, Ricca V, Maggi M. Cross-Sex hormone treatment and Psychobiological changes in transsexual persons: Two-Year Follow-Up data. J Clin Endocrinol Metab. 2016;101(11):4260–9. https://doi.org/10.1210/jc.2016-1276.

Article  CAS  PubMed  Google Scholar 

Scharff M, Wiepjes CM, Klaver M, Schreiner T, T’Sjoen G, den Heijer M. Change in grip strength in trans people and its association with lean body mass and bone density. Endocr Connections. 2019;8(7):1020–8. https://doi.org/10.1530/EC-19-0196.

Article  CAS  Google Scholar 

Wierckx K, Van Caenegem E, Schreiner T, Haraldsen I, Fisher AD, Toye K, Kaufman JM, T’Sjoen G. Cross-sex hormone therapy in trans persons is safe and effective at short-time follow-up: results from the European network for the investigation of gender incongruence. J Sex Med. 2014;11(8):1999–2011. https://doi.org/10.1111/jsm.12571.

Article  CAS  PubMed  Google Scholar 

Sánchez-Toscano E, Domínguez-Riscart J, Larrán-Escandón L, Mateo-Gavira I, Aguilar-Diosdado M. Cardiovascular risk factors in transgender people after Gender-Affirming hormone therapy. J Clin Med. 2023;12(19):6141. https://doi.org/10.3390/jcm12196141. Published 2023 Sep 23.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Gava G, Cerpolini S, Martelli V, Battista G, Seracchioli R, Meriggiola MC. Cyproterone acetate vs leuprolide acetate in combination with transdermal estradiol in transwomen: a comparison of safety and effectiveness. Clin Endocrinol (Oxf). 2016;85(2):239–46. https://doi.org/10.1111/cen.13050.

Article  CAS  PubMed  Google Scholar 

Gava G, Mancini I, Alvisi S, Seracchioli R, Meriggiola MC. A comparison of 5-year administration of cyproterone acetate or leuprolide acetate in combination with estradiol in transwomen. Eur J Endocrinol. 2020;183(6):561–9. https://doi.org/10.1530/EJE-20-0370.

Article  CAS  PubMed  Google Scholar 

Klaver M, van Velzen D, de Blok C, et al. Change in visceral fat and total body fat and the effect on cardiometabolic risk factors during transgender hormone therapy. J Clin Endocrinol Metab. 2022;107(1):e153–64. https://doi.org/10.1210/clinem/dgab616.

Article  PubMed  Google Scholar 

Quirós C, Patrascioiu I, Mora M, et al. Effect of cross-sex hormone treatment on cardiovascular risk factors in transsexual individuals. Experience in a specialized unit in Catalonia. Endocrinol Nutr. 2015;62(5):210–6. https://doi.org/10.1016/j.endonu.2015.02.001.

Article  PubMed  Google Scholar 

Hashemi L, Marijic Buljubasic A, Budoff MJ, et al. Gender-Affirming hormone treatment and metabolic syndrome among transgender veterans. JAMA Netw Open. 2024;7(7):e2419696. https://doi.org/10.1001/jamanetworkopen.2024.19696. Published 2024 Jul 1.

Article  PubMed  PubMed Central  Google Scholar 

Ceolin C, Scala A, Scagnet B, Citron A, Vilona F, De Rui M, Miscioscia M, Camozzi V, Ferlin A, Sergi G, Garolla A, GIIG group. Body composition and perceived stress levels in transgender individuals after one year of gender affirming hormone therapy. Front Endocrinol (Lausanne). 2024;15:1496160. https://doi.org/10.3389/fendo.2024.1496160.

Article  PubMed 

Comments (0)

No login
gif