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Research Letter
February 15, 2021

Association of High-Density Lipoprotein Cholesterol With Sex Steroid Treatment in Transgender and Gender-Diverse Youth

Author Affiliations
  • 1Division of Endocrinology, Ann & Robert H. Lurie Children’s Hospital, Chicago, Illinois
  • 2Department of Pediatrics, Children’s Hospital Los Angeles, Los Angeles, California
  • 3Division of Adolescent Medicine, Lurie Children’s Hospital, Chicago, Illinois
  • 4Division of Pediatric Endocrinology, Benioff Children’s Hospital, University of California, San Francisco, San Francisco
  • 5Division of Endocrinology, Boston Children’s Hospital, Boston, Massachusetts
JAMA Pediatr. Published online February 15, 2021. doi:10.1001/jamapediatrics.2020.5620

Mortality and morbidity from cardiovascular disease differ between men and women, and sex differences in lipid profiles may contribute to this difference. Starting at puberty, male individuals have more atherogenic cholesterol profiles, including lower high-density lipoprotein cholesterol (HDL-C) levels, than female individuals.1 The degree to which sex hormones vs sex chromosomes and other factors contribute to this difference is unknown. The gender-affirming treatment of transgender and gender-diverse youth provides a unique opportunity to study the association of sex steroids with cholesterol in different sex-chromosome contexts.

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