Gender-Affirming Hormone Treatment and Metabolic Syndrome Among Transgender Veterans
Authors' conclusion
In this cohort study, in both cisgender and transgender veterans, estradiol was associated with reduced metabolic syndrome risk, whereas testosterone was associated with increased risk. However, transmasculine individuals had the greatest risk and transfeminine individuals had the lowest risk of metabolic syndrome associated with these hormones. This is relevant for the management of metabolic syndrome risk factors in cisgender and transgender individuals and to potentially predict the risk of atherosclerotic cardiovascular disease, type 2 diabetes, systolic hypertension, insulin resistance, and nonalcoholic fatty liver disease.
Study context
- Population
- Transgender veterans with gender dysphoria diagnosis codes receiving documented estradiol or testosterone gender-affirming hormone treatment (GAHT), Veterans Health Administration national database, 2006–2019, matched to cisgender referents; mean (SD) age at index date 41.3 (13.2) years645 transgender, 645 cisgender
- Participants
- 1,290 veterans
- Exposure
- Transgender veterans receiving GAHT vs matched cisgender referents
- Transfemininen = 494
- Transmasculinen = 151
- Cisgender femalen = 280reference
- Cisgender malen = 365reference
- Outcome
- Change in mean metabolic syndrome z-scores (based on BMI, systolic blood pressure, HDL-C, TG and blood glucose) before vs after the index date (GAHT initiation)
Methodological detailslongitudinal, matched to cisgender referents
- Longitudinal
- Matched to cisgender referents
Main finding
As reported in the abstract
| Group | Value | P |
|---|---|---|
| Transmasculine | mean 298.0% (SE 57.0%) | P < .001 |
| Cisgender female | mean 108.3% (SE 27.5%) | P < .001 |
| Cisgender male | mean 49.3% (SE 27.5%) | P = .02 |
| Transfeminine | mean 3.0% (SE 10.7%) | P = .77 |
Value
P
Observational data: associations, not effects.
Original publication
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