ArticleInternational journal of transgender health2026
Effect of anti-androgens on body composition in transgender people: Secondary analysis of a randomized clinical trial.
Article in International journal of transgender health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Transgender people desiring feminization commonly use cyproterone acetate or spironolactone, but the optimal anti-androgen to achieve feminization of body composition is unclear. Aims: To assess the effect of anti-androgens on body composition. We hypothesized cyproterone acetate would result in a greater increase in body fat than spironolactone due to greater suppression of serum testosterone concentration and more potent androgen receptor antagonism. Methods: Secondary analysis of a randomized clinical trial of transgender people aged 18+ years newly commencing estradiol and randomized to spironolactone 100 mg daily or cyproterone acetate 12.5 mg daily for six months. Pre-specified secondary outcomes including waist circumference, hip circumference, waist/hip ratio and whole body dual x-ray absorptiometry (DXA). Results: Sixty-three people were included in intention-to-treat analysis (cyproterone acetate Discussion: Feminization of body composition was evident following six months of hormone therapy. Cyproterone acetate caused a greater increase in percentage total body fat, gynoid fat and android fat compared to spironolactone. Given the change in the android/gynoid fat ratio was similar, and that the waist/hip ratio did not change over time, it is unclear whether cyproterone acetate offers an advantage to spironolactone.
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