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Opposite to earlier analysis, transgender girls who use the hormone estradiol for his or her transition wouldn’t have an elevated threat of coronary heart assault and stroke in comparison with males within the basic Dutch inhabitants. That is proven by a large-scale examine from Amsterdam UMC, with information from greater than 4,000 transgender people, revealed within the European Coronary heart Journal.
The researchers suspect that the hormone remedy transgender girls obtain has a protecting impact on the center and blood vessels.
In transgender individuals, the intercourse assigned at delivery doesn’t match their skilled gender identification. A lot of them subsequently select hormone remedy to develop bodily traits that higher align with their gender identification, reminiscent of breast progress or a decrease voice.
For transgender girls, hormone remedy consists of the feminine hormone estradiol, usually together with a testosterone blocker. For transgender males, it’s the male hormone testosterone.
In transgender girls, but additionally in girls from the overall inhabitants, estradiol seems to have a protecting impact on the center and blood vessels.
Martin den Heijer, professor of endocrinology at Amsterdam UMC, says, “Earlier research urged the next threat of coronary heart assault and stroke for transgender girls in comparison with individuals with the identical delivery intercourse, that’s, males from the overall inhabitants. We didn’t actually perceive this.
“Now, however, we find no increased risk of heart and brain infarctions for transgender women who use estradiol. These findings fit well with what we know about the presumed protective effects of estradiol on the heart and blood vessels. With this research, we have solved a paradox that has occupied us for a long time.”
Earlier research on heart problems in transgender individuals have been usually small-scale and restricted to quick durations, which may clarify the sooner contradictory analysis outcomes.
The researchers from Amsterdam UMC analyzed information from greater than 4,000 transgender people and in contrast this with information from Statistics Netherlands (CBS), which collects well being information from your entire Dutch inhabitants. This makes it the biggest examine on this discipline thus far.
Components apart from hormone use
Transgender males who use testosterone do have an elevated threat of coronary heart assault and stroke, in comparison with girls from the overall Dutch inhabitants. That’s consistent with earlier research.
Mees van Zijverden, physician-researcher at Amsterdam UMC, says, “We know that testosterone use in transgender men can lead to slightly higher blood pressure and poorer cholesterol levels, which increases the risk of cardiovascular disease.”
However, these adjustments don’t appear to be adequate to clarify the rise in threat. The researchers assume that components apart from hormone use most likely additionally play a task within the elevated threat of heart problems in transgender males.
“That is why we also looked at lifestyle and socio-economic factors in the study, such as education level, employment history and income. However, these factors were found to explain only a small part of the increased risk,” says van Zijverden. Extra analysis is subsequently wanted into the precise causes of the elevated threat in transgender males.
“If we have a better understanding of the factors that play a role, we can improve care for transgender people. The number of transgender people who use hormones is growing worldwide. This group is also getting older. This means that cardiovascular disease will become an increasingly important point of attention in the future,” provides van Zijverden
For now, in keeping with the researchers, it’s important that transgender males and well being care suppliers are conscious of the elevated threat of heart problems, so that spotlight is paid to sustaining a wholesome way of life.
It is usually essential that threat components, reminiscent of hypertension or ldl cholesterol, are monitored in transgender males. In fact, this stays essential for transgender girls as nicely.
Extra data:
Lieve Mees van Zijverden et al, Transgender individuals receiving gender-affirming hormone remedy: threat of acute cardiovascular occasions in a Dutch cohort examine, European Coronary heart Journal (2025). DOI: 10.1093/eurheartj/ehaf837
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