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. 2023 Oct 30;177(12):1332–1341. doi: 10.1001/jamapediatrics.2023.4588

Figure 2. Bone Mineral Density (BMD) z Score Development and Mean Change at 4 Time Points and 3 Regions of Interest.

Figure 2.

Estimated by mixed-model analyses. The median (IQR) duration of gender-affirming hormone (GAH) treatment at short-term follow-up (FU) was 5.3 (4.3-6.3) years in individuals assigned male at birth and 5.7 (4.7-6.1) years in individuals assigned female at birth. The median (IQR) duration of GAH treatment at long-term FU was 11.6 (10.1-14.7) years in individuals assigned male at birth and 11.9 (10.2-13.8) years in individuals assigned female at birth. At the start of gonadotropin-releasing hormone agonist (GnRHa) treatment, 3 individuals assigned male at birth and 2 individuals assigned female at birth had missing dual-energy x-ray absorptiometry (DXA) scans. At the start of GAH treatment, DXA scans were missing in 5 individuals assigned male at birth and 8 individuals assigned female at birth. At short-term FU, DXA scans were not available for 11 individuals assigned male at birth and 20 individuals assigned female at birth. No DXA scans were missing at long-term FU. Circles indicate areal BMD and whiskers, 95% CIs. Mean changes in BMD z scores between all 4 time points are listed in eTable 2.