Klaver M, de Blok C J M, Wiepjes C M, Nota N M, Dekker M J H J, de Mutsert R, Schreiner T, Fisher A D, T'Sjoen G, den Heijer M
Department of Endocrinology and Center of Expertise on Gender Dysphoria, VU University Medical Center, Amsterdam, the Netherlands.
Department of Clinical Epidemiology, Leiden University and Medical Center, Leiden, the Netherlands.
Eur J Endocrinol. 2018 Feb;178(2):163-171. doi: 10.1530/EJE-17-0496. Epub 2017 Nov 28.
Cross-sex hormonal therapy (CHT) in trans persons affects their total body fat and total lean body mass. However, it is unknown how separate body regions are affected and whether these changes alter body shape. Therefore, the aim of this study was to determine the effects on body fat and lean body mass in separate body regions and on body shape after one year of CHT.
In a multicenter prospective study at university hospitals, 179 male-to-female gender dysphoric persons, referred to as transwomen, and 162 female-to-male gender dysphoric persons, referred to as transmen, were included. All underwent whole-body dual-energy X-ray absorptiometry and anthropometric measurements before and after one year of CHT.
In transwomen, increases in body fat ranged from +18% (95% CI: 13%;23%) in the android region to +42% (95% CI: 37%;46%) in the leg region and +34% (95% CI: 29%;38%) in the gynoid region. In transmen, changes in body fat ranged from -16% (95% CI: -19;-14%) in the leg region and -14% in the gynoid region (95% CI: -16%;-12) to no change in the android region (+1%, 95% CI: -3%;5%). Waist-to-hip ratio (WHR) decreased in transwomen (-0.03, 95% CI: -0.04;-0.02) mainly due to an increase in hip circumference (+3.2 cm, 95% CI: 2.3;4.0). Transmen have a decrease in hip circumference (-1.9 cm, 95% CI: -3.1;-0.7) resulting in an increase in WHR (+0.01, 95% CI: 0.00;0.02).
CHT causes a more feminine body fat distribution and a lower WHR in transwomen and a more masculine body fat distribution with a lower hip circumference in transmen.
跨性别者的跨性别激素疗法（CHT）会影响其全身脂肪和总体瘦体重。然而，尚不清楚身体各部位是如何受到影响的，以及这些变化是否会改变体型。因此，本研究的目的是确定CHT治疗一年后对身体各部位脂肪和瘦体重以及体型的影响。
在大学医院进行的一项多中心前瞻性研究中，纳入了179名男性至女性性别焦虑者（称为跨性别女性）和162名女性至男性性别焦虑者（称为跨性别男性）。所有人在接受CHT治疗一年前后均接受了全身双能X线吸收测定法和人体测量。
在跨性别女性中，身体脂肪增加幅度从男性化区域的+18%（95%CI：13%；23%）到腿部区域的+42%（95%CI：37%；46%）以及女性化区域的+34%（95%CI：29%；38%）。在跨性别男性中，身体脂肪变化幅度从腿部区域的-16%（95%CI：-19%；-14%）和女性化区域的-14%（95%CI：-16%；-12%）到男性化区域无变化（+1%，95%CI：-3%；5%）。跨性别女性的腰臀比（WHR）下降（-0.03，95%CI：-0.04；-0.02），主要是由于臀围增加（+3.2 cm，95%CI：2.3；4.0）。跨性别男性的臀围减小（-1.9 cm，95%CI：-3.1；-0.7），导致WHR增加（+0.01，95%CI：0.00；0.02）。
CHT使跨性别女性的身体脂肪分布更具女性特征且WHR降低，使跨性别男性的身体脂肪分布更具男性特征且臀围减小。
