Context Transgender adolescents can receive GnRH analogues (GnRHa) and gender affirming hormone therapy (GAHT), but little is known about effects on growth and adult height. This is of interest since height differs between sexes and some trans girls wish to limit their growth. Objective Investigate effects of GnRHa and GAHT on growth, and the efficacy of growth-reductive treatment. Design Retrospective cohort study. Setting Specialised tertiary gender clinic. Participants 161 trans girls treated with GnRHa and estradiol at a regular dose (2 mg) or high growth-reductive doses of estradiol (6 mg) or ethinylestradiol (EE, 100-200 µg). Main outcome measures Growth, adult height and difference from predicted adult height (PAH) and target height. Results Growth velocity and bone maturation decreased during GnRHa, but increased during GAHT. Adult height after regular dose treatment was 180.8 ± 5.4 cm which was 2.2 cm below PAH at start GnRHa (95%CI 0.8 to 3.6), and close to target height (-0.2 cm, 95%CI -1.5 to 1.1). Compared to regular dose treatment, high dose estradiol and EE reduced adult height by 1.8 cm (95%CI -0.6 to 4.1) and 4.1 cm (95%CI 0.6 to 7.6), respectively. Conclusion Growth decelerated during GnRHa and accelerated during GAHT. After regular dose treatment, adult height was slightly lower than predicted at start of GnRHa, likely due to systematic overestimation of PAH as described in boys from the general population, but not significantly different from target height. High dose EE resulted in greater reduction of adult height than high dose estradiol, but this needs to be weighed against possible adverse effects.
Context Growth is an important topic for many transgender boys. However, few studies have investigated the impact of puberty suppression (PS) and gender affirming hormone treatment (GAHT) on growth and adult height. Objective To evaluate the effect of PS and GAHT on growth and adult height. Design Retrospective cohort study. Setting Specialised gender identity clinic. Participants 146 transgender boys treated with GnRH analogues and testosterone who reached adult height. Main outcome measures Growth, bone age (BA), adult height, and difference between adult height and predicted adult height (PAH) and midparental height. Results In those with BA ≤14 year at start (n = 61), a decrease in growth velocity and bone maturation during PS was followed by an increase during GAHT. Adult height was 172.0 ± 6.9 cm; height SDS was similar to baseline (0.1, 95% CI -0.2 to 0.4). Adult height was 3.9 ± 6.0 cm above midparental height and 3.0 ± 3.6 cm above PAH at start of PS. A younger BA at start PS was associated with an adult height significantly further above PAH. Conclusion During PS, growth decelerated followed by an acceleration during GAHT. Although adult height SDS was similar to baseline, adult height was taller than predicted based on BA at baseline, especially in those who started treatment at a younger BA. It is reassuring that PS and GAHT do not have a negative impact on adult height in transgender boys and might even lead to a slightly taller adult height, especially in those who start at a younger age.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.