Gender dysphoria: puberty blockers and loss of bone mineral density

Cohen and Barnes clearly articulate the ongoing debate on the effects of puberty blockers (gonadotrophin releasing hormone (GnRH) agonists) on bone mineral density in trans and gender diverse young people.1 Contention remains as to whether use of GnRH agonists in adolescents causes slow bone accrual, static accrual, or bone loss. Contributing to the confusion is that previous studies have focused on mean changes in …