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. 2024 Nov 28:15:1496160.
doi: 10.3389/fendo.2024.1496160. eCollection 2024.

Body composition and perceived stress levels in transgender individuals after one year of gender affirming hormone therapy

Chiara Ceolin  1   2   3 , Alberto Scala  3   4 , Bianca Scagnet  4 , Anna Citron  1 , Federica Vilona  1 , Marina De Rui  1 , Marina Miscioscia  3   5   6 , Valentina Camozzi  3   7 , Alberto Ferlin  3   4 , Giuseppe Sergi  1   3 , Andrea Garolla  3   4 ; GIIG group
Affiliations

Body composition and perceived stress levels in transgender individuals after one year of gender affirming hormone therapy

Chiara Ceolin et al. Front Endocrinol (Lausanne). .

Abstract

Introduction: Higher stress levels are linked to increased body fat and decreased bone density, effects that can be exacerbated by lifestyle choices. This is particularly relevant for transgender and gender diverse (TGD) individuals, who often face additional stress from transphobia and social stigma. However, there is limited research on how stress affects body composition and bone health in TGD individuals, particularly in relation to gender-affirming hormone therapy (GAHT). This study examines the impact of perceived stress on these factors in TGD individuals before and after one year of GAHT, compared to a cisgender control group.

Methods: The study assessed 181 individuals, including 74 TGD participants (44 assigned female at birth [AFAB] and 30 assigned male at birth [AMAB]) and 107 controls (56 AFAB and 51 AMAB). Fifty-seven TGD participants completed follow-up one year after starting GAHT. Data collected included clinical history, blood tests, body composition, bone density, and quality of life assessments (Patient Health Questionnaire-9 [PHQ-9] and Perceived Stress Scale [PSS]).

Results: After one year of GAHT, TGD AFAB individuals showed a bone mineral density (BMD) similar to cisgender AMAB individuals, while TGD AMAB individuals' BMD remained significantly lower than cisgender controls. TGD AFAB individuals experienced increases in muscle strength (+8% from baseline), while TGD AMAB individuals showed a 24% increase in fat mass from baseline and an approximate 8% reduction in lean mass. PSS and PHQ scores, initially higher in TGD individuals, did not change significantly after one year of GAHT. A significant correlation was found between body fat percentage and PHQ and PSS scores at baseline and one year after GAHT, respectively.

Discussion: These findings reveal a complex relationship between GAHT, body composition, and perceived stress in TGD individuals, highlighting the need for further research on stress and health outcomes in this population.

Keywords: PHQ; PSS; body composition; bone mineral density; stress; transgender.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision.

Figures

Figure 1
Figure 1
Changes in FMI, ASMMI, and muscle strength from baseline to one year after the initiation of GAHT. CIS, Cisgender; TGD, Transgender; AFAB, Assigned Female At Birth; AMAB, Assigned Male At Birth; FMI, Fat Mass Index; ASMMI, Appendicular Skeletal Muscle Mass Index; HGM, Handgrip max strength test. *p<0.05; ***p<0.001.
Figure 2
Figure 2
Correlations between PSS, fat, and FMI in the transgender population. FMI, Fat Mass Index; PSS, Perceived Stress Scale.
See this image and copyright information in PMC

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