"The sex hormones estrogen and testosterone are critical regulators of bone health, contributing in different but complementary ways to the development of bone strength and structure during puberty. The typical patterns and timing of pubertal development are significantly altered in transgender youth who undergo gender-affirming hormone therapy (GAHT) during adolescence, and the effects of these hormonal regimens on the process of bone development are not fully understood. Transgender youth, particularly youth transitioning from male to female, may have delays in development of overall bone strength that improve over time...In a survey published by The Trevor Project in 2019, nearly 2% of youth identified as transgender, more than double a 2017 estimate from a survey of adults. And while not every transgender individual undergoes gender-affirming hormone therapy, young people identifying as transgender and their families need more information about the effects of GAHT on bone health to minimize risk and improve long-term health outcomes."
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