Community Conversation => Transitioning => Hormone replacement therapy => Topic started by: Briah on July 10, 2018, 10:31:50 AM Return to Full Version
Title: Kaiser Health Study of Trans Women
Post by: Briah on July 10, 2018, 10:31:50 AM
Post by: Briah on July 10, 2018, 10:31:50 AM
Kaiser Health just published a study of trans women on HRT and found an increased level of clotting issues around cardiac, lung, and stroke risk.
In reading it there was actually nothing really new in this. We knew of these risks some time ago and CIS women experience the same thing when on HRT. The good news is that the researchers found that the increased risk was very small and that most trans women would accept the risk willingly for the gains of hrt.
Just interesting reading and valuable information for those of use that are on hrt or considering it in making informed decisions around our health care.
In reading it there was actually nothing really new in this. We knew of these risks some time ago and CIS women experience the same thing when on HRT. The good news is that the researchers found that the increased risk was very small and that most trans women would accept the risk willingly for the gains of hrt.
Just interesting reading and valuable information for those of use that are on hrt or considering it in making informed decisions around our health care.
Title: Re: Kaiser Health Study of Trans Women
Post by: MikeP on July 10, 2018, 10:56:58 AM
Post by: MikeP on July 10, 2018, 10:56:58 AM
Thanks for the heads up. In the study does it separate the different medications used for HRT. IE anti androgen, estrogen, progesterone. I have read a lot of things including how the medication is given has different effects like pills creams injections pellets.
Mike
Mike
Title: Re: Kaiser Health Study of Trans Women
Post by: Lucy Ross on July 10, 2018, 11:16:18 AM
Post by: Lucy Ross on July 10, 2018, 11:16:18 AM
No dosages, or info on types of medications, or control patients. And it's the best study yet.
Title: Re: Kaiser Health Study of Trans Women
Post by: Briah on July 10, 2018, 11:34:29 AM
Post by: Briah on July 10, 2018, 11:34:29 AM
There is a great deal that this study doesn't look at. First off, it did not look at any anti androgen being prescribed, or for that matter any other medications or over the counter medications that may have been taken. It didn't identify what estrogen source was being taken. It didn't look at history or rule out family history of problems. It didn't look at lifestyle.
The sample sizes were statistically significant for what they were looking at: are there any increased health issues with trans women.
Now they get to start teasing out some of the other factors.
And in the report that I read I had to laugh because they said that for trans men there was no increased incidence of the same problems. Yep! Because they weren't taking estrogen, they were taking testosterone.
The sample sizes were statistically significant for what they were looking at: are there any increased health issues with trans women.
Now they get to start teasing out some of the other factors.
And in the report that I read I had to laugh because they said that for trans men there was no increased incidence of the same problems. Yep! Because they weren't taking estrogen, they were taking testosterone.
Title: Re: Kaiser Health Study of Trans Women
Post by: MikeP on July 10, 2018, 11:40:49 AM
Post by: MikeP on July 10, 2018, 11:40:49 AM
Quote from: Lucy Ross on July 10, 2018, 11:16:18 AM
No dosages, or info on types of medications, or control patients. And it's the best study yet.
It is too bad there are not more good studies. I have for years wondered why we cant get straight answers to normal T and E with criteria of age gender ethnic etc. When I see between 300 and 1100 is normal it does not give much to go on.
I think these studies would help decide what path someone might need to take. I am hoping my MD and endo have better information available to them.
Thanks. Mike :-\
Title: Re: Kaiser Health Study of Trans Women
Post by: Lucy Ross on July 10, 2018, 05:34:53 PM
Post by: Lucy Ross on July 10, 2018, 05:34:53 PM
The article I read pointed out that some MDs might use this as justification to deny meds, which is ridiculous. It's so cursory, they were incapable of using placebos too - can you imagine suffering from GD and being fed sugar pills for 6 months?
Nevertheless this popped up in my Google News feed this morning so it has a bit of traction, and I hope more chime in pointing out more of this study's weaknesses.
Nevertheless this popped up in my Google News feed this morning so it has a bit of traction, and I hope more chime in pointing out more of this study's weaknesses.
Title: Re: Kaiser Health Study of Trans Women
Post by: Virginia on July 10, 2018, 08:33:21 PM
Post by: Virginia on July 10, 2018, 08:33:21 PM
Link to article:
http://www.dailymail.co.uk/health/article-5935593/Transgender-women-higher-risk-strokes-blood-clots-taking-hormones-study-finds.html
It seems Kaiser chose the wrong baseline for the study. The prevalence of stroke/blood clotting in MTF's should have been compared to cisgender MEN not women. With a family history of coronary disease, this was the a huge concern to me and my wife when I was prescribed HRT. My OBGYN explained that the increase in probability of coronary disease I would experience by increasing my estrogen levels was insignificant compared to the DECREASE in probability of coronary disease I would experience by decreasing my testosterone levels.
http://www.dailymail.co.uk/health/article-5935593/Transgender-women-higher-risk-strokes-blood-clots-taking-hormones-study-finds.html
It seems Kaiser chose the wrong baseline for the study. The prevalence of stroke/blood clotting in MTF's should have been compared to cisgender MEN not women. With a family history of coronary disease, this was the a huge concern to me and my wife when I was prescribed HRT. My OBGYN explained that the increase in probability of coronary disease I would experience by increasing my estrogen levels was insignificant compared to the DECREASE in probability of coronary disease I would experience by decreasing my testosterone levels.
Title: Re: Kaiser Health Study of Trans Women
Post by: Briah on July 10, 2018, 09:49:12 PM
Post by: Briah on July 10, 2018, 09:49:12 PM
@Virginia--How true it is. The other thing that they should have considered is CIS woman who are on HRT who also have an increased incidence of cardiovascular issues.
@Lucy--I suspect that the human subjects and ethics committees would have had serious cardiovascular events if they had used placebos for this study.
Actually the study was just a review of medical records but they had some 5K trans persons and some 50K non trans persons to do the comparisons.
Also remember that correlation is NOT causation!
Still they are looking at it. As for doctors that might use it as a reason to not prescribe, I suspect that those doctors are already refusing to prescribe and this would just be something that they could wrongly use to justify their own bias.
@Lucy--I suspect that the human subjects and ethics committees would have had serious cardiovascular events if they had used placebos for this study.
Actually the study was just a review of medical records but they had some 5K trans persons and some 50K non trans persons to do the comparisons.
Also remember that correlation is NOT causation!
Still they are looking at it. As for doctors that might use it as a reason to not prescribe, I suspect that those doctors are already refusing to prescribe and this would just be something that they could wrongly use to justify their own bias.