Purpose

Transgender/gender-diverse (TGD) youth are treated with gonadotropin-releasing hormone agonists (GnRHas) to halt endogenous puberty and prevent the development of secondary sex characteristics discordant with their gender identity. This treatment may have significant impact on growth and height velocity (HV).

Methods

Participants were recruited prior to GnRHa initiation from four gender specialty clinics in the U.S. Anthropometric, laboratory, and Tanner-stage data were abstracted from medical records.

Results

Fifty-five TGD youth (47% designated male at birth) with a mean ± standard deviation age of 11.5 ± 1.2 years were included in the analysis. HV in the first year of GnRHa use was median (interquartile range) 5.1 (3.7–5.6) cm/year. Later Tanner stage at GnRHa initiation was associated with lower HV: 5.3 (4.4–5.6) cm/year for Tanner stage II, 4.4 (3.3–6.0) cm/year for Tanner stage III, and 1.6 (1.5–2.9) cm/year for Tanner stage IV (p = .001). When controlled for age, there was not a significant difference in mean HV between TGD youth and prepubertal youth; however, when stratified by Tanner stage individuals starting GnRHa at Tanner stage IV had an HV below that of prepubertal youth, 1.6 (1.5–2.9) versus 6.1 (4.3–6.5) cm/year, p = .006.

Conclusions

Overall, TGD youth treated with GnRHa have HV similar to that of prepubertal children, but TGD youth who start GnRHa later in puberty have an HV below the prepubertal range. Ongoing follow-up of this cohort will determine the impact of GnRHa treatment on adult height.

中文翻译：

---

促性腺激素释放激素激动剂治疗第一年变性/性别多元化青年的成长

目的

跨性别/性别多样化 (TGD) 青年接受促性腺激素释放激素激动剂 (GnRHas) 治疗，以阻止内源性青春期并防止与其性别认同不一致的第二性征的发展。这种治疗可能对生长速度和身高增长速度 (HV) 有重大影响。

方法

参与者是在 GnRHa 开始之前从美国的四个性别专业诊所招募的人体测量学、实验室和 Tanner 阶段数据是从医疗记录中提取的。

结果

分析中包括 55 名 TGD 青年（47% 出生时指定为男性），平均 ± 标准差年龄为 11.5 ± 1.2 岁。GnRHa 使用第一年的 HV 中位数（四分位数间距）5.1 (3.7–5.6) 厘米/年。启动 GnRHa 的晚期 Tanner 分期与较低的 HV 相关：Tanner II 期为 5.3 (4.4–5.6) cm/年，Tanner III 期为 4.4 (3.3–6.0) cm/年，Tanner III 期为 1.6 (1.5–2.9) cm/年Tanner IV 期 ( p  = .001)。当控制年龄时，TGD 青年和青春期前青年之间的平均 HV 没有显着差异；然而，当按 Tanner 阶段个体进行分层时，在 Tanner IV 阶段开始使用 GnRHa 的个体的 HV 低于青春期前的青年，分别为 1.6 (1.5–2.9) 和 6.1 (4.3–6.5) 厘米/年，p  = .006。

结论

总体而言，接受 GnRHa 治疗的 TGD 青少年的 HV 与青春期前儿童的 HV 相似，但在青春期后期开始使用 GnRHa 的 TGD 青少年的 HV 低于青春期前的范围。对该队列的持续随访将确定 GnRHa 治疗对成人身高的影响。