The Effects of Testosterone Gender-Affirming Hormonal Therapy on Body Composition and Psychosocial Well-being in Transmen

Abstract Introduction: The aim is to assess the effects of testosterone therapy on changes in the body composition and psychosocial well-being among treatment-naïve transmen. Methods: This is a prospective interventional study conducted over two years in a transgender clinic. The parameters measured were body mass index (BMI), waist-hip ratio (WHR), grip strength, in addition to serum levels of testosterone and estradiol. The body composition indices that include fat mass, lean body mass, android and gynoid regional fat distribution were measured and compared by dual energy x-ray absorptiometry (DXA). The psychosocial aspects of gender dysphoria were assessed with the GPSQ (gender dysphoria and stability questionnaire) scale, and quality of life was evaluated by the RAND SF-36 at baseline and one year of Gender-affirming hormone therapy (GAHT). Results: Sixty-eight transgender males were included in the study. The one year of GAHT had significant increase in BMI, grip strength, lean body mass (29.25 ± 6.63 to 35.82 ± 4.46 kg, P = 0.001), WHR ( P = 0.025) and android fat (1.22 ± 1.36 into 1.74 ± 1.46 kg, P = 0.001), whereas significant reduction in total fat mass (17.07 ± 12.70 into 12.00 ± 10.51 kg, P = 0.001) and gynoid fat (3.59 ± 1.86 into 1.74 ± 1.46 kg, P = 0.001) was observed. There was a positive correlation between WHR and android fat distribution ( r = 0.5). GPSQ scales and quality-of-life scores significantly improved at the end of the study. Conclusion: Testosterone GAHT helps in alleviating gender dysphoria as well as significant improvement in the desired body composition. The WHR may be used as a simple clinical tool to assess the android fat redistribution following testosterone therapy.