Vlot MC, et al. - Among 121 trans women (median age 30 years, IQR 24-41) and 132 trans men (median age 24 years, IQR 21-33) during the first year of hormonal treatment (HT), researchers examined changes in bone turnover markers (BTMs), sclerostin and correlations with the change in BMD. For this investigation, trans men received testosterone, whereas trans women received estradiol and anti-androgens. At baseline and after 1 year of HT, sclerostin, P1NP, alkaline phosphatase (ALP), CTx, and BMD of total hip (TH), femoral neck (FN), and lumbar spine (LS) were assessed. There were no variations in the age in trans women, whereas a decline in all BTMs was discovered in trans men aged ≥50 years as opposed to the other age groups. According to findings, one year of HT led to a reduced bone turnover in trans females and elderly trans males, while it increased in younger trans males. Especially the reduction in bone resorption in elderly trans men shows the significance of estrogen as a main bone turnover regulator.