Several studies in the past have suggested that transgender people may be at a higher risk of developing myocardial infarction and early death due to cardiovascular disease. Most of these studies indicated that this increased might the result of the hormone therapy that many transgender individuals go through for masculinization and feminization.
A review, which was authored by Michael S. Irwig, MD, associate professor of medicine at the George Washington University (GW) School of Medicine and Health Sciences, and also the director of the Andrology Center at the GW Medical Faculty Associates, examined several of these previously done studies that talked about hormone therapy that transgender people undergo.
“Many transgender patients take either testosterone or estrogen for masculinization or feminization,” Irwig explained. “Some studies have suggested that transgender people have an increased risk for heart attack and death due to cardiovascular disease.”
The review titled “Cardiovascular Health in Transgender People” was published recently in the Reviews in Endocrine and Metabolic Disorders. It focuses on cardiovascular processes such as myocardial infarction, stroke and venous thromboembolism, and surrogate marker too- like blood pressure and lipid concentrations– in transgender patients who were on hormone therapy, who may or may not have experienced gender affirmation procedures.
Almost all of the studies that the review has covered show that it is transgender women who actually are at an higher risk of developing cardiovascular disorders, while the data about transgender men wasn’t so clear. The studies say that this increased risk in transgender women is because of the estrogen hormone therapy that transgender women go through, and many already know that estrogen therapy that trans women undergo significantly increases the risk of developing blood clots (deep venous thromboses).
“In clinical studies that followed transgender patients, rates for myocardial infarction were consistently higher in transgender women on estrogen therapy than in transgender men on testosterone,” said Irwig. “The relationship between endogenous sex hormones and heart disease is complex. In cisgender women, estrogen may have a protective effect.”
Since hormone therapy is quite necessary in the management process of transgender patients, Irwig notes that further research should be done on the effects and risk of hormone therapy in older trans adults and safer forms of estrogen hormone therapy.