Overview

This observational study will evaluate the effect of puberty suppression on insulin sensitivity, metabolic rate and vascular health among transgender female youth at baseline and 6 months after initiation of a gondoatropin releasing hormone agonist compared to matched cisgender male controls.

Eligibility

Inclusion Criteria:

• Identify as a transgender female or cisgender male
• Age 9-14 years at the time of enrollment
• Tanner Stage 2-3 baseline pubertal development
• Plan to start gonadotropin releasing hormone analogue clinically in < 2 months (for transgender females only)

Exclusion Criteria:

• Cognitive, psychiatric, or physical impairment resulting in inability to tolerate the study procedures
• Type 1 or 2 diabetes (by medical history)
• On any medications that affect insulin sensitivity (e.g. metformin, antipsychotics)
• Hypertension (resting BP ≥ 140/90 mm/Hg)
• Weight > 400 lbs
• On estrogen- or progesterone-containing medications at baseline
• >3 hours of moderate-to-vigorous physical activity on the 3DPAR at the screening visit