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Does (mis)use of industrial liquid silicone implants interfere with bone mineral density in transgender women?

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Abstract

Summary

The effects of gluteal implants on bone mass remain unclear. Transgender women with ILS presented higher BMD in the hip compared with transgender women without implants, while no difference was observed in other sites. These results may be artifactual and suggest using spine/forearm sites for DXA in individuals with ILS.

Purpose

The inappropriate use of industrial liquid silicone (ILS) injections for cosmetic purposes is practiced by some transgender women. The aim of this study was to evaluate the impact of gluteal ILS on femur BMD in transgender women.

Methods

A total of 46 trans women with and without ILS injection in the gluteal region were selected. All patients underwent clinical and hormonal evaluation, and bone mass was assessed by DXA.

Results

Bone mineral density (BMD) values were significantly higher in trans women with ILS (n = 23) in femoral neck and total femur when compared with trans women without implants (n = 23). Similar BMD was observed in other sites, such as lumbar spine and forearm. Good agreement was found in the evaluation of low BMD using spine/forearm or spine/femur in patients without implants (k = 0.744 and 1.000 for male and female reference database, respectively), but poor to fair index was found in patients with ILS implants (k = 0.330 and 0.646 for male and female reference database, respectively).

Conclusions

In transgender women with ILS implants, poor to moderate agreement was found on BMD when comparing lumbar spine/femur DXA with an alternative site to the femur, depending on using male or female database. These results may be artifactual and suggest using spine/forearm sites for more accurate DXA assessments in trans women with ILS gluteal implants.

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All data generated or analyzed during this study are included in this manuscript.

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Funding

This work was supported by the Brazilian National Institute of Hormones and Women’s Health/Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq INCT grant number 465482/2014-7), and Fundação de Amparo à Pesquisa do Rio Grande do Sul (FAPERGS INCT grant number 17/2551-0000519-8). Financial support was also provided by FIPE-HCPA (Hospital de Clínicas de Porto Alegre Research and Event Support Fund). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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Authors and Affiliations

  1. Gynecological Endocrinology Unit, Division of Endocrinology, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos 2350, Porto Alegre, RS, 90035-003, Brazil

    Tayane Muniz Fighera, Eliane Dias da Silva, Gustavo da Silva Borba & Poli Mara Spritzer

  2. Gender Identity Program, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil

    Tayane Muniz Fighera, Eliane Dias da Silva & Poli Mara Spritzer

  3. Department of Physiology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil

    Poli Mara Spritzer

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  1. Tayane Muniz Fighera
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  2. Eliane Dias da Silva
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  3. Gustavo da Silva Borba
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  4. Poli Mara Spritzer
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Correspondence to Poli Mara Spritzer.

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Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individuals participants included in the study.

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Fighera, T.M., da Silva, E.D., Borba, G. et al. Does (mis)use of industrial liquid silicone implants interfere with bone mineral density in transgender women?. Arch Osteoporos 15, 149 (2020). https://doi.org/10.1007/s11657-020-00824-2

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