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DXA Scan Variants in Transgender Patients.

Quinnlyn Walcott1, Johnathan Dallman1, Hanna Crow2

  • 1The University of Kansas School of Medicine, Kansas City, KS, USA.

Journal of Clinical Densitometry : the Official Journal of the International Society for Clinical Densitometry
|May 7, 2022
PubMed
Summary
This summary is machine-generated.

Incorrect bone density measurements are common for transgender and gender non-conforming (TGNC) individuals. 67% of dual energy x-ray absorptiometry (DXA) scans in a study used the wrong sex for T- and Z-score calculations, impacting TGNC healthcare.

Keywords:
DXAT-scoreTransgenderZ-scorenon-binary

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Area of Science:

  • Endocrinology
  • Radiology
  • Health Disparities

Background:

  • Transgender and gender non-conforming (TGNC) individuals experience significant healthcare barriers and disparities.
  • Gender-affirming therapies, including hormone replacement therapy (HRT), are increasingly used, but long-term effects on bone health remain understudied.
  • The International Society of Clinical Densitometry (ISCD) provided guidelines in 2019 for dual energy x-ray absorptiometry (DXA) use in TGNC populations.

Approach:

  • A retrospective analysis reviewed DXA scan data from TGNC patients.
  • HERON software was used to query electronic health records for patient demographics, medications, gonadectomy status, and DXA scan information.
  • DXA T-scores and Z-scores were evaluated for accuracy based on ISCD guidelines.

Key Points:

  • 67% of reviewed DXA T-scores and Z-scores for TGNC patients were calculated incorrectly.
  • Incorrect calculations stemmed from using the patient's assigned sex at birth rather than sex relevant to ISCD guidelines.
  • This highlights a gap in the application of established guidelines for TGNC individuals.

Conclusions:

  • Current healthcare standards based on sex assigned at birth can lead to errors in diagnostic scoring for TGNC patients.
  • There is a critical need for improved training for healthcare professionals on TGNC-specific care protocols.
  • Further research is required to understand the long-term impact of incorrect DXA scans and the effects of HRT on bone mineral density in TGNC individuals.