Cardiovascular Disease Risk Estimation for Transgender and Gender-Diverse Patients: Cross-Sectional Analysis of Baseline Data From the LITE Plus Cohort Study

Treatment of Cardiovascular Manifestations in Transgender Individuals

The transgender population has been steadily increasing, with more individuals seeking gender-affirming care to align their physical characteristics with their gender identity. Despite advances in healthcare, transgender individuals face significant barriers to accessing culturally competent care, resulting in heightened cardiovascular risks and disparities. Cardiovascular disease prevalence among transgender individuals is influenced by a combination of physiological, psychological, and social factors, including the impacts of gender-affirming hormone therapy, surgical interventions, and minority stress. This review examines the cardiovascular risks associated with estrogen therapy in transfeminine individuals and testosterone therapy in transmasculine individuals, highlighting their effects on lipid profiles, thromboembolic risks, and metabolic parameters. Furthermore, it explores the implications of gender-affirming surgeries and the role of psychosocial stress in cardiovascular outcomes. Current evidence underscores the need for tailored risk assessment, proactive management strategies, and lifestyle interventions to optimize cardiovascular health in this population. Significant research gaps remain regarding the long-term cardiovascular effects of gender-affirming care. Large-scale, prospective studies and the development of transgender-specific cardiovascular care guidelines are crucial to address these gaps. This review advocates for a multidisciplinary, patient-centered approach to mitigate cardiovascular risks and improve outcomes for transgender individuals.

Considerations in the Care of Transgender and Gender-Diverse Patients Requiring Invasive Cardiac Catheterization

Transgender and gender diverse patients undergoing cardiac procedures require unique considerations to ensure the delivery of respectful, safe, and high-value health care. There are several issues for which practicing clinicians may have limited experience managing, including the potential interactions between gender-affirming medical and surgical interventions and cardiovascular conditions; using correct patient name and pronouns and additional strategies to increase comfort and safety of medical interventions; and nuances of cardiac clearance before gender-affirming surgeries. This article provides a primer on these topics and sets cardiologists up to learn more about the needs of transgender and gender diverse patient populations.