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Monitoring Long-Term Cardiovascular Risk from Estrogen Use in Transgender Women (Evidence Update for Clinicians)

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Many transgender women pursue medical transition with hormone therapy to help align their bodies with their female gender identity. Findings from this PCORI-funded study, which showed increased cardiovascular risks from estrogen use in transgender women, may help transgender women and their clinicians plan for ongoing health care.

The study found that incidences of venous thromboembolism (VTE) and ischemic stroke (IS) were higher in transgender women receiving estrogen than in cisgender men and women. The difference in risk increased over time. After eight years, the study found 17 excess cases of VTE per 1,000 transgender women compared with cisgender men and 14 excess cases of VTE per 1,000 transgender women compared with cisgender women. Transgender women had higher rates of myocardial infarction than cisgender women; these rates were similar to those observed in cisgender men.

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