Electronic Theses and Dissertations



Document Type


Degree Name

Master of Science



Committee Chair

Tracy Bruen

Committee Member

Sara Foley

Committee Member

Sara Zellers


Background: This article is an examination of the effects of hormone replacement therapy on bone health and density in transgender individuals. The use of gender affirming hormone therapy and surgery is on the rise nationally. This bears the question: what side effects may result from use? Hormones have previously been studied for their protective effects on bone health, but there is a distinct lack of research into the effects of long-term gender-affirming hormone therapy. Objective: To answer the research question: What effect does gender-affirming hormone therapy have on bone density in adult and adolescent transgender individuals over at least a 12-month period. Design: Scoping literature review utilizing sources from January 2011 to September 2022. The academic databases used in the collection of sources include PubMed and CINAHL Complete. Participants/Setting: Studies selected must have participants that identify as transgender and currently be receiving, or have previously received, gender-affirming hormone therapy. Inclusion criteria for adolescent individuals was identical to adults, with the addition that they must be past Tanner Stage II in puberty. Main Outcome Measure: It was hypothesized that the use of estrogen therapy in individuals would have a protective effect on bone mineral density and health, whereas testosterone therapy would have a deleterious effect when used on its own. Results/Conclusion: The use of gender-affirming therapy in transgender individuals is recognized as safe for adults and adolescents. Estrogen therapy had a mostly protective effect on bone mineral density, which reduces fracture and osteoporosis risk. Testosterone therapy had less effect on bone mineral density. While there were some incidences of bone mineral density growth, overall testosterone had a neutral effect on bone health. In adolescents, GnHR agonists were the primary treatment and resulted a in decrease of bone mineral density. This deleterious effect was lessened with the addition of sex hormones.


Data is provided by the student

Library Comment

Dissertation or thesis originally submitted to ProQuest.


Open Access