Endocrine Abstracts

JOINT3432

Introduction: Transgender people receive hormone treatments of the opposite sex during the transition process. There are many studies showing that the cardiovascular risks of individuals change as a result of this transition process. It is well-known that transgender individuals have changes in body composition, body fat distribution, and cardiovascular lipid profile.

Methods: Records of 81 female-to-male and 19 male-to-female patients over the age of 18 who applied to the endocrinology and metabolic diseases outpatient clinic of Ankara University Faculty of Medicine between 2018-2024 were reviewed. We aimed to investigate whether there is a change in cardiovascular risk in both transgender men and women during the transition process using some simple laboratory indices. Lipid parameters requested before treatment and at the 3rd, 6th, and 12th months of treatment, as well as during final follow-ups, were analyzed for transgender men receiving testosterone therapy.

Results: Of the 100 patients evaluated, 81 (81%)were transgender male whereas 19 (19%) were transgender female. The average age at first hospital admission was 22.45 years (SD: 4.425), and the average age at which symptoms were first noticed was 10.3 years (SD: 3.65). Based on this data, there was an average delay of 12.1 years between the onset of symptoms and seeking medical help. Among the 81 patients applying for female-to-male transition, 22 (27.1%) reported using a testosterone preparation obtained independently, without medical supervision. Additionally, 16 patients (19.7%) underwent mastectomy before the transition process upon their own decision, and 2 patients (2.49%) had undergone hysterectomy before transitioning. For evaluating cardiovascular risk profiles of the transgender male, Castelli risk index-1 (Total cholestrol/HDL-C), cardiac risk ratio-II (LDL/HDL-C), and triglyceride/HDL ratios were analyzed before treatment and during follow-up. The total cholesterol/HDL ratio was found to have increased significantly (P = 0.016), the LDL/HDL ratio also showed a significant increase (P = 0.03), while the triglyceride/HDL ratio did not show a statistically significant change (P = 0.887).

Conclusion: We found an increase in Castelli 1 Risk Score and CRI-II, but no difference in tg/HDL-C in transgender males after testosterone therapy. It is known that gender-affirming masculinization treatments can lead to elevated blood pressure, changes in lipid profiles, and increased hematocrit levels, thereby raising cardiovascular risks. This suggests that these young individuals who will receive long-term testosterone therapy should be carefully monitored for other cardiovascular risks throughout their lives, and appropriate medical agents should be used if necessary.