It is female people who take puberty blockers and then testosterone that have the greatest bone density issues. Maybe this will help.
Bone density issues caused by GnRH
Bone Health in the Transgender Population
Published online 2019 Jul 2.
Micol S. Rothman and Sean J. Iwamoto
www.ncbi.nlm.nih.gov/pmc/articles/PMC6709704/
This
Also unknown are the long-term effects of puberty blockade, the effect of changes in body composition and the optimal type, timing, dosage, and route of administration of GAHT for bone outcomes.
Conclusion
The results of the studies that reported impact on the critical outcomes of gender dysphoria and mental health (depression, anger and anxiety), and the important outcomes of body image and psychosocial impact (global and psychosocial functioning), in children and adolescents with gender dysphoria are of very low certainty using modified GRADE. They suggest little change with GnRH analogues from baseline to follow-up.
And
GnRH analogues are frequently employed to provide puberty blockade in adolescents with gender incongruence or gender dysphoria. From their use in other medical conditions such as prostate cancer, their deleterious effects on the bone are well known, although these have the potential to be reversible if treatments are stopped or add back therapies can be given
And
However, Z-scores in the trans boys also showed an expected drop during GnRHa treatment. Similarly, they did not fully make up their bone loss as Z-scores at age 22 were still lower than baseline
Meaning, the authors acknowledge little is known about the lasting effects of puberty blockers. In this study, they propose some positive effect from cross sex hormones for females but ths results show that it doesn’t really make up the loss from puberty blockers.