How do you view the efficacy of estrogen replacement therapy in trans-women with regards to osteoporosis prevention and treatment?

How do you screen and treat osteoporosis in trans-women?

• HRT is enough therapy for healthy young trans-women without risk factors.
• I use prophylactic bisphosphonate doses for osteopenic patients with risk factors.
• I get a screening DXA scan every 1-2 years, regardless of their risk profile.
• I do not screen for osteoporosis unless they have a history of fragility fractures.
• Other