ESPE Abstracts (2021) 94 FC5.1

1Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.;2Zaans Medical Centre, Zaandam, Netherlands.;3Ghent University Hospital, Ghent, Belgium

Introduction: Little is known about the effects of puberty suppression (PS) and hormone therapy (HT) on growth and adult height in transgender adolescents. These are topics of interest since height differs between sexes and some transgirls wish to limit their growth. In this longitudinal cohort study, we investigated the influence of PS and HT on growth and the efficacy of growth reduction therapy in transgender girls.

Methods: 88 transgirls who were treated with gonadotropin-releasing hormone agonists (GnRHa) and estradiol, with a bone age ≤ 16 at start PS and who had reached adult height were included. Adult height was compared to predicted adult height (PAH, using bone age according to B&P) at start PS, and to target height. Outcomes were compared between transgirls treated with a regular estradiol dose (regular increase up to adult dose of 2 mg) and high dose estradiol to reduce growth (fast increase up to 6 mg).

Results: Transgirls treated with a regular estradiol dose (n = 47) had a mean (±SD) age of 13.8 ± 1.0 years at start PS and 16.2 ± 0.5 years at start HT. They reached an adult height of 180.8 ± 5.4 cm (male height SDS -0.51 ± 0.77; female SDS +1.51 ± 0.88). Adult height was 0.5 ± 4.1 cm above target height and 3.3 ± 4.7 cm below PAH at start PS. Transgirls treated with high dose estradiol (n = 20) were 13.0 ± 1.0 years at start PS and 15.3 ± 0.8 years at start HT. Their adult height was 184.9 ± 5.7 cm (male height SDS +0.20 ± 0.81; female SDS +2.30 ± 0.91). Adult height was 0.2 ± 6.9 cm below target height and 4.5 ± 5.5 cm below PAH. The distance between target height and adult height or between PAH and adult height was not significantly different between adolescents treated with regular versus high dose estradiol, respectively 0.8 cm (95% CI -2.4 to 4.0) and 1.2 cm (95% CI -1.7 to 4.1).

Conclusion: In both treatment groups, mean adult height was close to target height but lower than PAH. This indicates that treatment with GnRHa and estradiol might have an impact on adult height. Alternatively, prediction formulas might overestimate adult height in transgirls. Remarkably, treatment with high dose estradiol did not result in a significant growth reduction compared to the regular dose. The effect of timing and duration of PS and estradiol treatment on growth deserves further study.

Volume 94

59th Annual ESPE (ESPE 2021 Online)

22 Sep 2021 - 26 Sep 2021

European Society for Paediatric Endocrinology 

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