The Effect of Gender-Affirming Hormone Therapy on the Risk of Subclinical Atherosclerosis in the Transgender Population: A Systematic Review
Authors' conclusion
The results suggest that GAHT is associated with an increased risk of subclinical atherosclerosis in transgender men but may have either neutral or beneficial effects in transgender women. The evidence produced is not entirely conclusive, suggesting that additional studies are warranted in the context of primary prevention of CV disease in the transgender population receiving GAHT.
Study context
- Population
- Transgender men and women before and during/after gender-affirming hormone therapy (GAHT) for at least 2 months12 studies
- Comparison
- Transgender people before and during/after GAHT vs cisgender men and women or hormonally untreated transgender persons
- Outcome
- Changes in variables of endothelial function, arterial stiffness, autonomic function and blood markers of inflammation/coagulation associated with cardiovascular (CV) risk (subclinical atherosclerosis)
Methodological detailsPRISMA guidelines, PubMed, LILACS, EMBASE and Scopus searched
- PRISMA guidelines
- PubMed, LILACS, EMBASE and Scopus searched
Pooled result
As reported in the abstract
Markers of subclinical atherosclerosis
- Trans men receiving GAHT: increased carotid thickness, brachial-ankle pulse wave velocity, and decreased vasodilation
- Trans women receiving GAHT: decreased interleukin 6, plasminogen activator inhibitor-1, and tissue plasminogen activator levels and brachial-ankle pulse wave velocity
- Trans women: variations in flow-mediated dilation and arterial stiffness depending on type of treatment and route of administration
- 8 cross-sectional and 4 cohort studies
Original publication
The Effect of Gender-Affirming Hormone Therapy on the Risk of Subclinical Atherosclerosis in the Transgender Population: A Systematic Review. Endocr Pract. Published 2 January 2023. doi:10.
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