A recent study from Amsterdam UMC has found that transgender women using the hormone estradiol do not face an increased risk of heart attacks and strokes compared to men in the general Dutch population. This significant research, published in the European Heart Journal, analyzed data from over 4,000 transgender individuals and challenges previous studies that suggested otherwise.
The findings indicate that the hormone treatments transgender women undergo may provide protective benefits for the heart and blood vessels. Transgender individuals, who identify with a gender different from the sex assigned at birth, often seek hormone therapy to align their physical characteristics with their gender identity. For transgender women, this typically involves estradiol, sometimes combined with a testosterone blocker.
New Insights into Cardiovascular Health
Martin den Heijer, a professor of endocrinology at Amsterdam UMC, expressed relief at the study’s findings. He noted, “Earlier studies suggested a higher risk of heart attack and stroke for transgender women compared to people with the same birth sex, that is, men from the general population. We did not really understand this.” The recent analysis shows no increased risk of heart or brain infarctions among transgender women using estradiol, aligning with existing knowledge of estradiol’s protective effects.
Previous research on cardiovascular health in transgender individuals has often been limited in scope, leading to inconsistent results. By utilizing comprehensive data from Statistics Netherlands, which gathers health statistics from the entire Dutch population, this study stands as the largest of its kind to date.
Understanding Risks for Transgender Men
In contrast, transgender men using testosterone do exhibit an increased risk of heart attack and stroke when compared to women in the general Dutch population. This trend aligns with findings from earlier studies. Mees van Zijverden, a physician-researcher at Amsterdam UMC, noted that testosterone can lead to elevated blood pressure and adverse cholesterol levels, both of which contribute to cardiovascular risk.
Despite these known effects, the precise reasons behind the increased cardiovascular risk in transgender men remain unclear. The researchers examined various lifestyle and socio-economic factors, including education level, employment history, and income. They found these factors explained only a small portion of the increased risk.
Van Zijverden emphasized the importance of understanding the underlying causes of cardiovascular disease in transgender men. “If we have a better understanding of the factors that play a role, we can improve care for transgender people,” he stated. As the population of transgender individuals seeking hormone therapy grows and ages, cardiovascular health will become an increasingly critical issue.
In light of the findings, it is essential for transgender men and healthcare providers to remain vigilant about the heightened risk of cardiovascular disease. Monitoring risk factors such as high blood pressure and cholesterol levels is crucial for this demographic. This proactive approach is equally important for transgender women, who should also prioritize cardiovascular health.
The study’s insights into the health of transgender individuals could significantly influence future medical practices and guidelines. The complete research is detailed in the article titled “Transgender persons receiving gender-affirming hormone therapy: risk of acute cardiovascular events in a Dutch cohort study,” available in the European Heart Journal (2025).
