What is it about?
We evaluated 29 studies to determine the effects of sex steroids on changes in lipid profile, including total, LDL and HDL cholesterol; triglycerides; cardiovascular events, including myocardial infarction, transient ischemic attack and stroke, and venous thromboembolism events; and mortality in transgender adults.
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Why is it important?
Low quality evidence suggests that sex steroid therapy may increase LDL cholesterol and triglycerides and decrease HDL cholesterol levels in female to male individuals, while oral estrogens may increase triglycerides in male to female individuals. Data about patient important outcomes such as myocardial infarction and stroke remain sparse.
Perspectives
Clinicians prescribing cross-sex hormonal therapy need to share with transgender individuals the current uncertainty regarding potential side effects of masculinizing/feminizing hormone therapy and make treatment decisions based on patients’ values, preferences and context. Future research is needed to ascertain the safety of hormone therapies in transgender individuals. Randomized trials nested within study center cohorts could test the relative safety of different cross-sex hormone regimens. Moreover, the medical centers that provide care to transgender individuals should make it a priority to conduct long-term follow-up studies evaluating patient-important outcomes. In this context, observational studies in which baseline cardiovascular risk is assessed and balanced between study groups with proper ascertainment of exposure and outcomes measures are also feasible and urgently needed
Spyridoula Maraka
Read the Original
This page is a summary of: Sex Steroids and Cardiovascular Outcomes in Transgender Individuals: A Systematic Review and Meta-Analysis, The Journal of Clinical Endocrinology & Metabolism, September 2017, Endocrine Society,
DOI: 10.1210/jc.2017-01643.
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