Research has shown that transgender women on hormone therapy could be at higher risk for cardiovascular problems. These problems include strokes, heart attacks, and blood clots.
The study reviewed eight years of medical records of almost 5,000 patients in the Kaiser Health system. It looked at patients over 18 years of age who took hormones for their gender transition. More than 97,000 cisgender patients with similar health histories were also studied as the control group. Cisgender individuals are those whose gender identity coincides with the sex assigned to them at birth.
Dr. Darios Getahun, one of the study’s authors and research scientist at Kaiser Permanente said this is the largest ever study so far on the health of transgender people on hormone therapy. He continued saying Doctors and patients alike need to know about the possibility of increased health risks for transgender women.
The study found that trans women were twice as likely as cisgender men or women to have venous thromboembolism, the blood clot condition. Studies also found Trans women on hormone therapy are 80 to 90 percent more likely than cis women to have a stroke or heart attack.
Transgender men on hormone therapy, on the other hand, did not appear to have a higher risk.
Reviews of the records have limitations and aren’t yet enough to create a direct cause and effect, according to Getahun. He noted the study only had access to the patients’ records at Kaiser. In fact, the dosage and type of hormones used by patients were unknown.
Traditional studies of giving a placebo to one group while giving the real product to another won’t work well in this situation. The practice of providing artificial transition hormones without a patient’s knowledge or consent is ethically prohibitive.
Studies Used to Treat Transgender Women as Cisgender Women in Menopause
Past studies showed measuring cardiovascular effects of estrogen therapy done with menopausal women and then applied to transgender women. However, this study found significant differences, especially for long-term use. While studies with menopausal women saw the possibility of the illness decline over the years, it was the opposite for transgender women over time.
Thankfully, Dr. Joshua Safer, another one of the study’s authors said that while the cardiovascular risk is higher for trans women, it’s not too high. Out of the 2,842 trans women in the past eight years, doctors only recorded 148 with cardiovascular problems.
Dr. Richard Greene, associate professor of medicine, is a primary care doctor with many trans patients. He said transgender people are often denied hormone therapy. A person’s gender identity is also usually not a considered factor in medical studies.
The doctors involved in the study stress that the therapy is highly essential and saves many lives of transgendered individuals who struggle with depression and even consider suicide when denied the needed treatment.
The risks are no different from a variety of other medications or therapies used currently. The doctors want more studies on trans individuals to learn risks specific to them so they can have better care.