Endocrine Abstracts

JOINT724

Introduction: Transgender individuals exhibit a higher cardiovascular risk compared to the general population. Gender-affirming hormone therapy (GAHT), used to align physical characteristics with gender identity, has an unclear impact on cardiovascular risk factors. Some evidence suggests that GAHT may exacerbate cardiovascular risk through changes in blood pressure, insulin resistance, lipid profile, and body composition.

Objective: This study aims to evaluate the impact of GAHT on lipid profile, blood pressure, and body mass index (BMI) in transgender individuals.

Methods: A retrospective longitudinal study was conducted at a multidisciplinary clinic of transgender medicine from October 2021 to January 2024. The study collected and analysed sociodemographic data, lifestyle behaviours, medical history, and clinical data from all individuals observed during this period. From this population, a subset of participants with sufficient data at two or more time intervals was studied to evaluate changes in lipid profiles, blood pressure, and BMI from baseline up to one year after starting GAHT. Statistical analysis was performed using IBM SPSS Statistics 28.0.1.0 with a significance level of 0.05.

Results: The study included 232 transgender individuals (152 trans men and 80 trans women; median age 23) who showed high rates of tobacco use (37.3%) and illicit substance use (11.5%). Among trans feminine individuals, there were consistent but non-significant decreases in systolic blood pressure (SBP) and triglycerides (TG) at 3, 6, and 9 months. Trans masculine individuals exhibited a trend of increasing SBP, though no changes reached statistical significance. Trans masculine individuals experienced a significant increase in BMI at 3, 6, and 9 months (Δmax of 1.01 kg/m²; P<0.01) and a significant decrease in HDL cholesterol at all time points (Δmax of −10.47 mg/dl; P<0.001).

Conclusion: The observed trends suggest that GAHT may influence lipid profiles. Although these changes are statistically significant, their magnitude is typically not considered clinically relevant. As such, our data indicates that GAHT appears to be safe in the short term. However, the prevalence of other cardiovascular risk factors highlights the need for routine monitoring in this population. Further research is essential to address existing knowledge gaps regarding the long-term cardiovascular effects of GAHT.

Keywords: Transgender Persons; Cardiovascular Disease, Heart Disease Risk Factors, gender-affirming hormone therapy