Gender-affirming Hormone Therapy and Risk of Diabetes in Transgender Persons Comment

• Type of Material: Article
• Authors: Vin Tangpricha, Emory University
• Language: English
• Date: 2022-02-01
• Publisher: ENDOCRINE SOC
• Publication Version: Final Published Version
• Copyright Statement: © The Author(s) 2022. Published by Oxford University Press on behalf of the Endocrine Society.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1210/clinem/dgac060
• Title of Journal or Parent Work: JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM
• Volume: 107
• Issue: 6
• Start Page: E2632
• End Page: E2633
• Keywords: diabetes; cardiovascular; Science & Technology; estradiol; testosterone; Life Sciences & Biomedicine; Endocrinology & Metabolism; transgender
• Research Categories: Health Sciences, Medicine and Surgery

Abstract

Most transgender people request gender-affirming hormone therapy (GAHT) to affirm their gender identity and to improve quality of life and well-being (1). GAHT has been regarded as safe when following guidelines to ensure that sex hormone concentrations do not exceed values found in men and women (1). However, recent large cohort studies have raised concerns about the long-term risk of cardiovascular disease after receipt of GAHT (2, 3). Transgender women followed at the Amsterdam Cohort of Gender Dysphoria experienced higher than expected cardiovascular deaths compared to the general Dutch population (2). In the US-based STRONG cohort, transgender women had increased rates of stroke compared with cisgender men and women (3). The reasons for the increased rates of major cardiovascular events (MACEs) found in transgender women are unclear. Increased risk of diabetes may contribute to the increased risk of MACEs associated with GAHT. Early studies have suggested that GAHT worsens insulin resistance and risk of diabetes in transgender women (4). In addition, GAHT in transgender women has been associated with increased body mass index, which may further increase the risk of diabetes (5).