Research
Hormonal
Testosterone therapy in transgender men leads to increased lean mass and visceral adiposity, while estrogen therapy in transgender women leads to decreased lean mass and increased fat mass, confirming the causal role of sex steroids in body composition.
If you are undergoing gender-affirming hormone therapy, expect your body composition to shift towards your new hormonal profile. Trans men will likely gain muscle and visceral fat; trans women will likely lose muscle and gain subcutaneous fat. This is a direct result of the hormones, not lifestyle failure.
GoodSupportsHIGH confidence
Oestrogen therapy in transgender women was associated with a decrease in lean mass and waist-to-hip ratio and an increase in fat mass and BMI, while testosterone therapy in transgender man was associated with an increase in lean mass, increase in BMI and waist-to-hip ratio with a tendency to gain visceral adiposity and lose subcutaneous adiposity.
Why this rating
Based on a review of 20 studies.
Source
Sex- and Gender-Related Differences in Obesity: From Pathophysiological Mechanisms to Clinical Implications
Andrijana Koceva et al. · International Journal of Molecular Sciences · 2024
DOI 10.3390/ijms25137342
narrative_reviewCited 108×
Read the paper DOI resolved against Crossref · corpus check 2026-06-10
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- Premenopausal women exhibit sex-specific fat distribution characterized by preferential subcutaneous adipose tissue (SAT) storage and higher brown adipose tissue (BAT) activity, which provides metabolic protection against visceral obesity and cardiovascular disease compared to men.Good
- Menopause triggers a shift in fat distribution from protective subcutaneous tissue to harmful visceral adipose tissue due to declining estrogen levels, increasing the risk of metabolic disease.Good
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