Royal Osteoporosis Society

[ChristinaXYZ]

The Royal Osteoporosis Society has a feature on its website where you can assess your risk. On the second page where you state whether you are male or female once you've opted for one or the other it says: "If you’re transgender, your risk of osteoporosis and broken bones is unlikely to be affected, as long as you’re taking prescribed hormone replacement therapy."

Is that true? I thought for females at least osteoporsis was more likely if they went on to have hormone treatment to transition. Even if I have got that wrong is the true answer not really - we don't know because there are not enough studies on large enough numbers of people over enough time?

It also does not make clear that if you have had no treatment then your risk remains the risk of your birth sex.

How does this help a transgender person wanting to know their risk? Or at least what is known about their risk at the moment?

Is this another case of organisations and charities all being headed by the same merry-go-round set of identikit management professionals? High-powered office workers who have never spent a working day dealing with the issues that affect the grassroots service users?

I struggle to believe that anyone who had had a job helping patients manage osteoporosis could ever be this blase. Just witnessing one family member's slow deterioration from osteoporosis - ultimately caused by a teenage eating disorder -made me passionate about adolescent bone health.

But I think a team of clueless management professionals recruited externally could fuck up like this. Sadly, all they really know about their causes is the stuff they're paid to recite at the glossy awareness-rasing fundraisers.

I fear this is true. Ditto medical conferences, schools materials, the soft social sciences.
I think the brutal reality dawning that our so-called informed and apolitical institutions are indeed weak bullet-point spouting non-entities.

I guarantee you every endocrinologist not tied to the capture, every physical therapist like me that is sick of this bull crap propaganda, will be doing good by our individual patients.

The bigger issues are going to be teen wannabe transitioners and young adults who have already done so, and on the fast track to frailty, who will be misled badly, and who will use this disinformation as ammo to disagree or dissent from best practice, ensuring (hundreds of) thousands more bad outcomes.

Sinead Watson on X was talking recently about how her testosterone is still high and her Oestrogen low, several years after stopping taking T, and the devastating effects of cross-sex hormones on her body, which she was not warned about before starting them.

I saw that thread; I really do think she should have some real body identical hrt rather than the combined pill she's on. Or a mirena. ( or both) I can't help wondering if the pill is worsening her Mh.

So I discover on this thread that late puberty (tick) and premature menopause (tick) are risk factors for osteoporosis. It's a pity that my GP didn't know that or I might have had a bone density scan before I had two collapsed lumbar vertebrae rather than after. I had a third one collapse a couple of months ago but, since my bone density is still only 40% of target, I shouldn't have been surprised.

She says she's struggled to get any help, which seems to be a common theme with detransitioners. No-one seems to know what to do with them.

I'm sorry to hear that.

I'm worried too - not sure how late a late puberty is but I was 16 before periods started and went hypothyroid not long after. And that's been all over, including times where in retrospect I was probably on too much thyroxine for long periods as well as far too little which I know can be a risk. And late diagnosis of asthma so am on inhaled steroids for that.

Gp won't give me a bone scan when I ask. Had to come off hrt too. I'm lifting weights and taking vit d and did a ton of high impact sports in my 20s and 30s but I do worry.

Does anyone have links to any research that would provide answers to te underlying questions: ie (1) does long term use of testosterone by biological females — ie transmen — have an effect on bone density; (2) does long term use of estrogen by biological males (ie transwomen) have an effect on bone density; (3) do puberty blockers have long term effect on bone density?

Hi Warrior,

I'm not a doctor so don't take this as gospel.

My first period was when I was 15 but my menopause was all done and dusted by the time that I was 33. Most of what I have learned has been from the bone density technician. Don't worry about what impact exercise you took in the past. That ship has sailed and your skeleton has survived. There are three elements for healthy bones (ingnoring smoking and excess alcohol).

The first is Calcium. There is a diet sheet from the ROS but it is mainly common sense. Milk, cheese, yoghurt are no-brainers. But broad leaf vegetables and even sausage rolls and pork pies increase your Calcium intake.

The second is vitamin D. The lazy way is to take Calcium tablets with vitamin D. You will create more and better vitamin D if you can expose your forearms to daylight for 10 minutes every day. Pull your sleeves up unless it is raining.

The third is bone work. You just need to take 100 unsupported upward steps every day (the step being a normal house or office stair step). By unsupported I mean without using a bannister.

Seriously though, it would be useful to know if your bone density is a problem. If you are worried go to a private GP. The fee is about £40 but they can refer you to an NHS bone scan facility who will report back to your NHS GP.

I hope that you don't need to worry but don't let your GP act as a service preventer.