Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2021 Sep 30:12:718200.
doi: 10.3389/fendo.2021.718200. eCollection 2021.

Cardiovascular Risk Associated With Gender Affirming Hormone Therapy in Transgender Population

Gloria Aranda  1 , Irene Halperin  1   2 , Esther Gomez-Gil  3 , Felicia A Hanzu  1   2 , Núria Seguí  2 , Antonio Guillamon  4 , Mireia Mora  1   2
Affiliations
Review

Cardiovascular Risk Associated With Gender Affirming Hormone Therapy in Transgender Population

Gloria Aranda et al. Front Endocrinol (Lausanne). .

Abstract

Transgender men and women represent about 0.6 -1.1%% of the general population. Gender affirming hormone therapy (GAHT) helps ameliorate gender dysphoria and promote well-being. However, these treatments' cardiovascular (CV) effects are difficult to evaluate due to the limited number of extensive longitudinal studies focused on CV outcomes in this population. Furthermore, these studies are mainly observational and difficult to interpret due to a variety of hormone regimens and observation periods, together with possible bias by confounding factors (comorbidities, estrogen types, smoking, alcohol abuse, HIV infection). In addition, the introduction of GAHT at increasingly earlier ages, even before the full development of the secondary sexual characteristics, could lead to long-term changes in CV risk compared to current data. This review examines the impact of GAHT in the transgender population on CV outcomes and surrogate markers of CV health. Furthermore, we review available data on changes in DNA methylation or RNA transcription induced by GAHT that may translate into changes in metabolic parameters that could increase CV risk.

Keywords: cardiovascular risk; gender affirming hormone therapy; transgender men; transgender population; transgender women.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

References

    1. T’Sjoen G, Arcelus J, Gooren L, Klink DT, Tangpricha V. Endocrinology of Transgender Medicine. Endocr Rev (2019) 40(1):97–117. doi: 10.1210/er.2018-00011 - DOI - PubMed
    1. Dutra E, Lee J, Torbati T, Garcia M, Merz CNB, Shufelt C. Cardiovascular Implications of Gender-Affirming Hormone Treatment in the Transgender Population. Maturitas (2019) 129:45–9. doi: 10.1016/j.maturitas.2019.08.010 - DOI - PMC - PubMed
    1. Dhejne C, Lichtenstein P, Boman M, Johansson ALV, Lângtröm N, Landén M. Long-Term Follow-Up of Transsexual Persons Undergoing Sex Reassignment Surgery: Cohort Study in Sweden. PLoS One (2011) 6(2):e16885–5. doi: 10.1371/journal.pone.0016885 - DOI - PMC - PubMed
    1. Asscheman H, Giltay E, Megens JA, Pim de Ronde W, von Trotsenburg M, Gooren LJ. A Long-Term Follow-Up Study of Mortality in Transsexuals Receiving Treatment With Cross-Sex Hormones. Eur J Endocrinol (2011) 164(4):635–42. doi: 10.1530/EJE-10-1038 - DOI - PubMed
    1. Wierckx K, Van Caenegem E, Schreiner T, Haraldsen I, Fisher AD, Toye K, et al. . Cross-Sex Hormone Therapy in Trans Persons Is Safe and Effective at Short-Time Follow-Up: Results From the European Network for the Investigation of Gender Incongruence. J Sex Med (2014) 11(8):1999–2011. doi: 10.1111/jsm.12571 - DOI - PubMed

Publication types

MeSH terms