Gender-affirming hormone therapy and cardiovascular health in transgender adults.

Transgender patients appear to be at higher risk for cardiovascular diseases compared to their cisgender peers.

• This elevated risk is noted relative to cisgender peers in the general population.
• The review characterizes transgender populations as 'historically hard-to-reach,' contributing to limited data.
• The impact of gender-affirming therapy on cardiovascular health is described as 'unclear.'

Gender-affirming hormone therapy (GAHT) has wide-ranging effects on clinical and subclinical markers of cardiovascular risk.

• Effects are described as 'far-ranging' and affect both clinical and subclinical cardiovascular risk markers.
• The review covers cardiometabolic impact of GAHT for both transgender men and transgender women.
• Differences in GAHT regimens contribute to confounding in studies examining cardiovascular outcomes.

Studies on the cardiovascular effects of GAHT are confounded by significant methodological challenges.

• Confounders include differences in GAHT regimens across study populations.
• The transgender and gender non-binary population is described as 'diverse and historically hard-to-reach.'
• These methodological challenges make it difficult to draw definitive conclusions about GAHT's impact on cardiovascular outcomes.

Current cardiovascular guidelines do not incorporate gender identity or hormone status into risk stratification and clinical decision-making.

• This gap in guidelines applies to both risk stratification and clinical decision-making for transgender patients.
• The review identifies this as a significant clinical gap given the growing number of transgender individuals receiving GAHT.
• The paper aims to provide an overview of clinical considerations for cardiovascular risk in transgender patients to help address this gap.

The number of people identifying as transgender and gender non-binary is growing in the USA and worldwide, with a concomitant increase in patients receiving GAHT.

• Growth is noted both in the USA and globally.
• GAHT is being used to 'achieve gender congruence' in an increasing number of patients.
• This demographic trend underlies the clinical importance of understanding the cardiovascular implications of GAHT.