A new study, published in the Annals of Internal Medicine, has found a link between hormone replacement therapy (HRT) and cardiovascular issues – like blood clots, strokes and heart conditions – in trans women. The study focused on 2,800 transgender women and 2,100 transgender men, 23 percent of whom had undergone gender-affirming surgeries. They were all followed for four years each and matched against medical records from some 48,000 cis men and cis women with corresponding ages, races and ethnicities.
The study found transgender women were twice as likely to have venous thromboembolism, a dangerous type of blood clot. The risk seemed to be stem from HRT, as trans women were at five times higher risk of blood clots than cisgender men and three times higher than cisgender women. Trans women in the study also showed a higher rate of heart attacks and strokes than cis women.
Senior author Dr. Michael Goodman, an epidemiology professor at Emory University in Atlanta, explains that the study didn’t factor in differences in hormone doses, formulations, or combinations. He said the purpose of the study was to encourage further research.
“Our hope is people will understand we’re not trying to scare anybody,” Goodman told Reuters. “We’re just saying there are some questions that need to be answered to guide the therapy. Risks comes with benefits, and benefits come with risks. It takes a thoughtful healthcare provider and a well-educated patient to make an informed decision.”
Dr. Vin Tangpricha, an endocrinologist at Emory University and a co-author of Goodman’s study, says that if you’re concerned about cardiovascular issues the solution doesn’t have to mean stopping your HRT altogether, but rather implementing common-sense steps to limit risk factors, such as quitting smoking, and being aware of hypertension and habits that could lead to obesity. As always, talk to your doctor about any worries you might have concerning HRT.