Are Trans People More Susceptible to Cardiovascular Disease?

[Jessica_Rose ✅]

Are Trans People More Susceptible to Cardiovascular Disease? Researchers Still Have Questions

https://www.them.us/answers-and-advice/health/trans-people-cardiovascular-health 🔗

Quispe López (19 Oct 2026)

A new perspective piece published in a recent issue of the Journal of General Internal Medicine concludes that the cardiovascular health risks for trans people, especially regarding their possible interactions with hormone replacement therapy (HRT), are dangerously understudied. In the piece, researchers observe that amid heightened global scrutiny on gender-affirming healthcare, "insufficient effort has been made to address health disparities and fill health-related knowledge gaps impacting trans populations, particularly for [cardiovascular disease]."

The researchers assert that these stakes are especially high given that cardiovascular disease (CVD) remains the leading cause of death in the United States, accounting for more than a quarter (26.4%) of all deaths in the country. Consisting of scientists from the Boston University, University of Toronto, and Yale University, among other medical research institutions, the authors note that despite trans, gender-nonconforming and nonbinary people only making up 1.1% of the U.S. adult population, evidence suggests they experience disproportionate rates of CVD.

The question that remains for many trans patients is does their risk of cardiovascular disease increase when taking HRT? These researchers state that although the limited existing research suggests that gender-affirming hormone therapy (GAHT) can increase cardiovascular risk — with some data suggesting increased risk of blood clots for those who take estrogen and increased risk of high blood pressure for those who take testosterone — these findings draw from a very limited scope.
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@Sarah B

[Allie Jayne]

The University of California SanFrancisco paper on Feminising Hormones https://transcare.ucsf.edu/guidelines/feminizing-hormone-therapy 🔗 puts the risks of clots in perspective " Data on the risk associated with oral 17-beta estradiol are mixed, with some suggesting no increased risk and others suggesting a 2.5 - 4 fold increased risk.[20,44] Even in the case of a 2.5 fold increase, the background rate for VTE in the general population is very low (1 in 1000 to 1 in 10,000), so the absolute risk increase is minimal." In percentage terms this means at 4 times the risk, the percentage goes from 0.1% - 0.01% to 0.4% - 0.04%, or 99.6% safe (at background levels).

Cardiovascular risk rises with many factors, including chronic stress, and this is something most Trans people commonly experience. Any study into the effects of HRT on Cardiovascular disease must take these other factors into account. It is also important that the "Womens'Health Initiative' report, which forms the basis of many medical standards, is ignored, and studies are made on medicines in Current use.

In today's Transgender climate, I worry about the objectivity of studies, so we need to be vigilant to vet the studies and call out bias'.

Hugs,

Allie

[Karen_A]

Besides the lesser concern about blood clots from HRT, cardiovascular risk often depends on one's lipid profile which I think HRT actually helps (at least for a post-op).

I have been on HRT since about 1996 and this is my lipid profile (and I am overweight and out of shape at 71):

Cholesterol: 122 mg/dL (normal range <200 mg/dL)

HDL Cholesterol: 75 mg/dL (Normal > 40 mg/dL)

LDL Cholesterol: 39 mg/dL (Normal < 130 mg/dL)

Non-HDL Cholesterol: 47 mg/dL (normal < 160 mg/dL)

Triglycerides: 38 mg/dL (Normal (<150 mg/dL)

VLDL Cholesterol: 8 mg/dL (Normal 8 - 71 mg/dL)

[big kim]

Just been for an echo cardiograph ultrasound due to fibrillation. Benn on HRT since early 1990. Palpitations started after using a salbutamol sulphate inhaler.

[Devlyn ✅]

Are Trans People More Susceptible to Cardiovascular Disease? Researchers Still Have Questions

This trans person is. My aunt died during an angiogram. My mother flatlined during an angiogram, then flatlined again after they stabilized her. Thanks genetics. 😠

[Mariah ✅]

It is true that it is understudied, but genetics are going to the bigger factor. With that having been said, Estrogen pills can increase the risk for clots provided you are already high risk for them. I know when the DVT that resulted from the line they put in from antibiotics they were concerned about it simply because I did form a clot. We have not changed anything other than I'm on meds to break down the clot so it doesn't cause more harm in my body, but it doesn't prevent another clot from happening. This is one of those areas that if the risk is deemed to high your doctor will avoid things like pills when it comes to estrogen. Hugs
Mariah