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.