Risk of venous thromboembolism in the transgender population on hormone therapy: A systematic review.

Venous thromboembolism occurrence was significantly higher in transgender women than in cisgender men.

• OR: 2.23; 95% CI: 1.93–2.57; P<.001
• Five studies assessed the incidence of thromboembolic events in both transgender and cisgender populations
• Comparison was made against cisgender individuals of the same sex assigned at birth
• 21 total studies were included in the systematic review

No significant difference in venous thromboembolism risk was found between transgender men and cisgender women.

• OR: 0.96; 95% CI: 0.87–2.31; P=.60
• This comparison was also drawn against cisgender individuals of the same sex assigned at birth
• Five studies contributed data for this comparison

A systematic literature search across multiple databases identified 21 studies reporting venous thromboembolism incidence in transgender individuals on hormone therapy.

• Databases searched included PubMed, Cochrane Library, Scopus, and EMBASE
• All studies reporting data on venous thromboembolism incidence in transgender individuals on hormone therapy were eligible for inclusion
• 21 studies were ultimately included in the review

Hormone therapy in transgender women is associated with an increased risk of venous thromboembolism.

• The review concludes that gender-affirming hormone therapy in transgender women may increase VTE risk
• The finding is consistent with the known association between hormone therapy and increased thrombotic risk noted in the background
• The elevated OR of 2.23 supports a more than twofold increase in risk compared to cisgender men