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Transgender Hormone Therapy Increases the Risk of Heart Attack and Stroke, New Study Shows

AP Photo/Armando Franca

In recent months, several doctors, lawmakers and the like have sounded the alarm about the dangers of irreversible transgender “gender-affirming” care for minors. These treatments include puberty blockers, hormone therapy treatment, and sex reassignment surgery. Last fall, England’s National Health Service issued guidance stating that most children experiencing gender dysphoria are likely going through a “transient phase” and will outgrow it.

This week, a new study that will be presented at an American College of Cardiology conference in March found that patients who take cross-sex hormones  as part of their gender-affirmation therapy face a “substantially increased risk of serious cardiac events, including stroke, heart attack and pulmonary embolism.”

The study pointed out that hormone therapy use is escalating rapidly, as more than a million people in the United States identify as transgender, which Townhall covered. But, this demographic is “historically understudied,” it explained:

Researchers retrospectively examined rates of cardiovascular events in over 21,000 people with gender dysphoria from a national database of hospital records, of whom 1,675 had used hormone replacement therapy. Typically, people assigned male at birth receive estrogen and people assigned female at birth receive testosterone. Overall results found hormone replacements were associated with higher rates of cardiac events, mostly related to dangerous blood clots, but were not associated with higher rates of death.


In the study, people with gender dysphoria who had ever used hormone replacements saw nearly seven times the risk of ischemic stroke (a blockage in a vessel supplying blood to the brain), nearly six times the risk of ST elevation myocardial infarction (the most serious type of heart attack) and nearly five times the risk of pulmonary embolism (a blockage in an artery in the lung), compared with people with gender dysphoria who had never used hormone replacements. Hormone replacement therapy was not associated with any increase in deaths from any cause or with increased rates of atrial fibrillation, diabetes, hypertension, hemorrhagic stroke or heart failure.

Both estrogen and testosterone are known to increase the clotting activity of blood, which could explain the increase in clotting-related cardiovascular events, researchers said. Those taking hormone replacement therapy also had higher rates of substance use disorder and hypothyroidism.

“Starting transitioning is a big part of a person's life and helping them feel more themselves, but hormone replacement therapy also has a lot of side effects—it's not a risk-free endeavor," Ibrahim Ahmed, MD, who is a third-year resident at Mercy Catholic Medical Center and the study's lead author, said. Ahmed will present the study at the conference next month.

"Looking at a person's medical and family history should definitely be part of the screening protocol before they even start hormone replacement therapy," Ahmed added. "It is also important that people considering this therapy are made aware of all the risks."

This month, Jamie Reed, a former case manager at the Washington University Transgender Center at St. Louis Children’s Hospital, published a tell-all piece with The Free Press about the “morally and medically appalling” way children who walked through the clinic’s doors were treated for gender dysphoria. 

“By the time I departed, I was certain that the way the American medical system is treating these patients is the opposite of the promise we make to ‘do no harm.’ Instead, we are permanently harming the vulnerable patients in our care,” Reed wrote, adding that “anyone who raised doubts [about the care] ran the risk of being called a transphobe.”

Reed explained that children were given gender-affirming care after only a couple visits, and that their mental health conditions were often overlooked.

“The mental health of these kids was deeply concerning—there were diagnoses like schizophrenia, PTSD, bipolar disorder, and more. Often they were already on a fistful of pharmaceuticals,” Reed explained. “This was tragic, but unsurprising given the profound trauma some had been through. Yet no matter how much suffering or pain a child had endured, or how little treatment and love they had received, our doctors viewed gender transition—even with all the expense and hardship it entailed—as the solution.”

All in all, Reed claimed that experience felt like “building the plane while we are flying it."


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