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According to several studies, transgender individuals may be at higher risk for myocardial infarction and death due to cardiovascular disease. This increased risk may be due to the hormone therapy that transgender patients take for masculinization or feminization.
A review authored by Michael S. Irwig, MD, associate professor of medicine at the George Washington University (GW) School of Medicine and Health Sciences and director of the Andrology Center at the GW Medical Faculty Associates, examined several studies that followed transgender individuals on hormone therapy.
The review focuses on cardiovascular events (myocardial infarction, stroke and venous thromboembolism) and surrogate markers- including blood pressure and lipid concentrations in transgender patients on hormone therapy who may or may not have undergone gender affirmation procedures.
The studies that the review covers show that transgender women appear to have increased risk for cardiovascular events due to hormone therapy whereas the data is unclear for transgender men. It is well known that estrogen therapy for trans women increases their risk of blood clots.
Rates for myocardial infarction were consistently higher in transgender women on estrogen therapy than in transgender men on testosterone, the relationship between endogenous sex hormones and heart disease is complex. In transgender women, estrogen may have a protective effect.