Sex recorded at birth, gender identity, and feminizing gender-affirming hormone therapy (fGAHT) likely contribute to cardiovascular disease (CVD) risk in transgender women. Understanding the interplay of these factors is necessary for the provision of safe, affirming, and lifesaving care. Among transgender women taking fGAHT, data show increases in CVD mortality and rates of myocardial infarction, stroke, and venous thromboembolism compared to reference populations, depending on study design and comparators. However, most studies are observational with a paucity of contextualizing information (e.g., dosing, route of administration, gonadectomy status), which makes it difficult to parse adverse fGAHT effects from confounders and interaction with known CVD risk factors (e.g., obesity, smoking, psychosocial and gender minority stressors). Increased CVD risk in transgender women points toward a need for greater attention to CVD management in this population including cardiology referral when indicated and additional research on the mechanisms and mediators of CVD risk.
Keyphrases
- cardiovascular disease
- palliative care
- polycystic ovary syndrome
- risk factors
- venous thromboembolism
- mental health
- healthcare
- type diabetes
- pregnancy outcomes
- breast cancer risk
- metabolic syndrome
- primary care
- weight loss
- hiv testing
- heart failure
- cervical cancer screening
- cardiac surgery
- coronary artery disease
- social media
- acute kidney injury
- atrial fibrillation
- stem cells
- hepatitis c virus
- body mass index
- pregnant women
- weight gain
- smoking cessation
- chronic pain
- subarachnoid hemorrhage
- physical activity
- left ventricular
- pain management
- gestational age