# Pubertal Blockade and Estradiol Effects on Cardiometabolic Health for Transitioning Youth (PUBERTY)

> **NIH NIH K23** · UNIVERSITY OF COLORADO DENVER · 2023 · $188,250

## Abstract

PROJECT SUMMARY/ABSTRACT
Candidate: Dr. Natalie Nokoff is a Pediatric Endocrinologist whose research and clinical focus is on the
cardiometabolic health of transgender youth. The goal of her K23 proposal is to acquire the critical research
skills necessary to lead high-quality, patient-centered clinical research. This training will help her achieve her
long-term goal of developing a successful independent research program and becoming an international expert
on the impact of sex steroids on cardiometabolic health.
Background: Up to 1.8% of adolescents in the U.S. identify as transgender. Treatment of transgender females
(male sex and a female gender identity, MTF) may include pubertal blockade (gonadotropin-releasing hormone
analogue or GnRHa) in early puberty followed by estradiol later in adolescence. The impact of these
treatments on cardiometabolic health is understudied and unclear. MTF adults on estradiol have higher rates of
vascular events than non-transgender (cisgender) individuals.
Research Plan: Pubertal Blockade and Estradiol Effects on Cardiometabolic Health for Transitioning Youth
(PUBERTY) is a longitudinal observational study to evaluate the impact of GnRHa and estradiol on
vascular function and insulin sensitivity (IS). Young MTF (n=15) will be evaluated before and 6 months
after GnRHa. A separate cohort of MTF youth (n=40, ages 13-16 years, 20 who clinically received a GnRHa
and 20 who did not) will be evaluated at baseline, 6 and 12 months after estradiol. MTF youth will be compared
to cisgender youth (n=15 males, 15 females), adjusted to pubertal stage and body mass.
Career Development Plan: Dr. Nokoff’s research career development training activities include: 1) gain
expertise in design and conduct of clinical studies (implementation and completion of the PUBERTY study,
coursework and a PhD in Clinical Investigation); 2) lean how to perform and interpret vascular studies; 3) learn
new methods for assessing IS.
Environment: The environment for this project is exceptional with a strong academic Section of Pediatric
Endocrinology at the University of Colorado Anschutz Medical Campus and resources of the Colorado Clinical
and Translational Sciences Institute and Center for Women’s Health Research. Dr. Nokoff is faculty in the
TRUE Center for Gender Diversity, a comprehensive, multidisciplinary clinic serving over 1,000 transgender
youth, that will assure successful recruitment for this study. Mentors with expertise in endocrinology, insulin
resistance, vascular health, sex steroids, working with vulnerable populations, and clinical investigation are
invested in this candidate’s future and will be instrumental in supporting her research and career development.
Impact: The results of this novel study will improve the clinical care of transgender youth and yield information
on risk factors for future vascular events. Dr. Nokoff will gain invaluable skills in study design as well as
assessment of vascular and metabolic health, launc...

## Key facts

- **NIH application ID:** 10666532
- **Project number:** 5K23HL151868-04
- **Recipient organization:** UNIVERSITY OF COLORADO DENVER
- **Principal Investigator:** Natalie J Nokoff
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2023
- **Award amount:** $188,250
- **Award type:** 5
- **Project period:** 2020-08-15 → 2025-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10666532

## Citation

> US National Institutes of Health, RePORTER application 10666532, Pubertal Blockade and Estradiol Effects on Cardiometabolic Health for Transitioning Youth (PUBERTY) (5K23HL151868-04). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10666532. Licensed CC0.

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