There’s new evidence that people taking hormones for gender transition may have a higher risk of cardiovascular problems.
Hints from previous hormone studies
Previous research has indicated that hormone therapy in general raises cardiovascular risk. For example, menopausal women taking estrogen and progestin had a 41% greater risk of stroke, a 29% greater risk of a heart attack and a 100% greater risk of blood clots. According to estimates from the National Institutes of Health, estrogen by itself raises the risk of stroke by 39% and the risk of blood clots by 47%.
With these increased risk factors in mind, a new study from Amsterdam University Medical Center set out to determine if hormone therapy during gender transitioning also raises the risk of cardiovascular problems.
Hormones during gender transition
The team looked at the medical records of 3,875 people who received hormone therapy for gender transitioning between 1972 and 2015.
The 1,358 transgender men had an average age of 23 and received testosterone therapy. The men were clinically followed for an average of 8 years after hormone therapy began.
The 2,517 transgender women had an average age of 30 and received just estrogen or estrogen and androgen suppressors. The women were clinically followed for an average of 9 years after hormone therapy began.
The findings
Looking at cardiovascular issues, including strokes, blood clots and heart attacks, the scientists found that trans women were:
• more than twice as likely to have a stroke (compared to cis women)
• almost twice as likely to have a stroke (compared to cis men)
• five times more likely to develop blood clots (compared to cis women)
• 4.5 times more likely to develop blood clots (compared to cis men)
• more than twice as likely have had a heart attack (compared to cis women)
In addition, trans men were more than three times more likely to have a heart attack than cis men.
Although the team didn’t account for risk factors like smoking, diet, exercise and stress, they theorize that hormone therapy is probably to blame for the increased cardiovascular risk.
