Schagen SEE, Wouters FM, Cohen-Kettenis PT, et al. - In this observational prospective study, researchers sought to characterize bone mass development in adolescents with gender dysphoria treated with gonadotropin-releasing hormone analogues (GnRHa), subsequently combined with gender-affirming hormones. Fifty-one transgirls and 70 transboys taking GnRHa and 36 transgirls and 42 transboys taking GnRHa and gender-affirming hormones, subdivided into early- and late-pubertal groups. According to findings, BMAD z-scores increased during gender-affirming hormone treatment and reduced during GnRHa treatment. At baseline and at the end of the study, transboys had normal z-scores. Transgirls, however, had relatively low z-scores, both at baseline and after 3 years of estrogen treatment. It is currently unknown if this results in adverse outcomes like increased fracture risk in transgirls as they grow older.