Metabolic and cardiovascular risks of hormone treatment for transgender individuals.

Masculinising hormone therapy (testosterone) produces atherogenic lipid profiles in transmen.

• Testosterone therapy consistently shifts lipid profiles in an atherogenic direction in transgender men.
• Effects on other metabolic parameters such as insulin resistance and body composition are not consistent across available studies.
• There is insufficient evidence to conclude whether overall cardiovascular disease risk among transmen is increased.

Transwomen have a greater risk of venous thromboembolism (VTE) compared to cisgender men and women.

• The risk of venous thromboembolism is described as 'greater in transwomen than in cis-gender men and women.'
• There is a 'possible increase in cardiovascular disease risk' among transwomen receiving feminising hormone therapy.
• The effects of feminising hormone therapy on metabolic parameters 'do not demonstrate a consistent pattern in the available literature.'

Identifying metabolic and cardiovascular risks of gender-affirming hormone therapy (GAHT) is complicated by confounding variables and diversity of treatment regimes.

• Confounding variables affecting patient outcomes make it challenging to isolate effects of GAHT.
• Diversity of treatment regimes across studies contributes to inconsistent findings in the literature.
• The inconsistency applies to both masculinising and feminising hormone therapy outcomes.

Clinical guidelines recommend baseline and periodic cardiovascular risk assessments for individuals receiving GAHT.

• It is recommended to 'discuss the potential effects of GAHT on cardiovascular health' with patients.
• Patients seeking GAHT should be encouraged 'to adopt a healthy lifestyle.'
• 'Performing baseline and periodic assessments of cardiovascular risk factors would enable early identification and interventions.'
• In high-risk individuals, 'the cardiovascular effects of hormonal regimes might impact the treatment decision.'