Impact of Gender-Affirming Hormone Therapy on Cardiovascular Health

Despite advances in the management of cardiovascular risk factors, the approach to the transgender population receiving hormone therapy is not completely defined. Transgender patients are those who present with "gender incongruence," that is, a discrepancy between the individual's expressed gender and the designated gender, which generally corresponds to the biological sex. In these cases, hormonal treatment differs from the "traditional" approach in that it is a "crossover" hormonal treatment. Multiple studies have evaluated the relationship between gender affirming hormone therapy (GAHT), the development of cardiovascular risk factors and the occurrence of cardiovascular events, both for the transfeminine and transmasculine population. These findings are particu-larly relevant, as cardiovascular disease is the second leading cause of mortality in the transgender population. However, studies that have attempted to stratify this group according to their cardiovascular risk have faced notable difficulties and limitations. The aim of this review is to investigate the impact of GATH on cardiovascular health, to assess the need to reconsider risk stratification and therapeutic targets for these patients, and to discuss the applicability of general recommendations to this specific population.