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A Review of Cardiovascular Outcomes in Transgender Men
Receiving Gender Affirming Hormone Therapy (GAHT) 2010-2022
Lauren Cohen, MD; Abdullah Noor, MD; Tara Banani; Rachel Chatfield; Emma Overmyer, MD; Karina Romo,
MD; Abdul Zia, MD; Christian Martinez; Gabriel Uwaifo, MD; Brandy Panunti, MD; Qasim Zafar Iqbal, MD
Department of Endocrinology, Ochsner Health, New Orleans, LA; Ochsner Clinical School/The University of Queensland, New Orleans, LA
Background
Results
Exploration of the short and long term effects
of estrogen GAHT has thus far been extensive
relative to that of testosterone GAHT. We aim
to further explore the relationship between
testosterone use and cardiovascular
outcomes in transgender men at Ochsner.
Methods
472
patients
History of
long-term
testosterone
use
6,372,443
patients
Ochsner patient
population in
Epic SlicerDicer
prior to filters
1,646
patients
Diagnosis or
medical history
of gender
identity disorder
January 2010 to
January 2022
CVD
morbidity
Filtered for
prevalence of
various
cardiovascular
risk factors
This exploration into the impact of testosterone
GAHT on cardiovascular risk demonstrates that
there are several aspects that warrant deeper
understanding and further research. Future
iterations will include:
1. Obtain detailed data pull of individual patients
2. Establish a comparison cohort
3. Analyze the prevalence of major CV events
(i.e. MI, strokes, etc)
4. Compare against general US population
We aim to benefit future patients by elucidating
the safety of using testosterone therapy for the
treatment of gender dysphoria in transgender
men, therefore potentially decreasing anxiety
and adverse outcomes with the initiation of this
therapy. Understanding the risks, benefits, and
side effects associated with testosterone
therapy is important to both providers and to
patients electing to use this treatment.
Purpose
Conclusions
References:
1. Spanos, Cassandra, et al.. Effects of gender-affirming hormone therapy on insulin resistance and body composition in transgender individuals: a systematic review. World Journal of Diabetes 2020; 11.3:66. 2. Martinez, Claudia, et al.. Gender identity, hormone therapy, and cardiovascular disease risk. Current problems in cardiology 2020; 45.5:100396. 3. Flores, A. R., et al.. How many adults identify as transgender in the United States?. The Williams Institute, UCLA
School of Law 2016; 4. Vitale, C., Fini, M., Speziale, G., & Chierchia, S.. Gender differences in the cardiovascular effects of sex hormones . Fundamental & clinical pharmacology 2010; 24(6):675-685. 5. Kalin, M. F., & Zumoff, B.. Sex hormones and coronary disease: a review of the clinical studies. Steroids 1990; 55(8):330–352. 6. Irwig M.S.. Cardiovascular health in transgender people. Reviews in endocrine & metabolic disorders 2018; 19(3):243-251. 7. Dutra, E., Lee,
J., Torbati, T., Garcia, M., Merz, C., & Shufelt, C.. Cardiovascular implications of gender-affirming hormone treatment in the transgender population. Maturitas 2019; 129:45-49. 8. Chan Swe N, Ahmed S, Eid M, Poretsky L, Gianos E, Cusano NE. The effects of gender-affirming hormone therapy on cardiovascular and skeletal health: A literature review. Metabol Open March 03, 20222; 13:doi: 10.1016/j.metop.2022.100173. 9. Gooren, Louis J., Katrien Wierckx, and Erik J.
Giltay. Cardiovascular disease in transsexual persons treated with cross-sex hormones: reversal of the traditional sex difference in cardiovascular disease pattern. Eur J Endocrinol 2014; 170.6:809-819. 10. Wierckx, Katrien, et al.. Prevalence of cardiovascular disease and cancer during cross-sex hormone therapy in a large cohort of trans persons: a case-control study. Eur J Endocrinol 2013; 169.4:471-478.