title: Prevalence of cardiovascular disease and cancer during cross-sex hormone therapy in a large cohort of trans persons: a case-control study.
abstract: OBJECTIVE
  This study evaluated the short- and long-term cardiovascular- and cancer-related morbidities during cross-sex hormone therapy in a large sample of trans persons.
  
  
  METHODS
  A specialist center cross-sectional study compared 214 trans women (male-to-female transsexual persons) and 138 trans men (female-to-male trans persons) with an age- and gender-matched control population (1-3 matching). The participants were on cross-sex hormone therapy for an average of 7.4 years. We assessed physical health and possible treatment-related adverse events using questionnaires.
  
  
  RESULTS
  Five percent of trans women experienced venous thrombosis and/or pulmonary embolism during hormone therapy. Five of these adverse events occurred during the first year of treatment, while another three occurred during sex reassignment surgery. Trans women experienced more myocardial infarctions than the control women (P=0.001), but a similar proportion compared with control men. The prevalence of cerebrovascular disease (CVD) was higher in trans women than in the control men (P=0.03). The rates of myocardial infarction and CVD in trans men were similar to the control male and female subjects. The prevalence of type 2 diabetes was higher in both trans men and women than in their respective controls, whereas the rates of cancer were similar compared with the control men and women.
  
  
  CONCLUSIONS
  Morbidity rate during cross-sex hormone therapy was relatively low, especially in trans men. We observed a higher prevalence of venous thrombosis, myocardial infarction, CVD, and type 2 diabetes in trans women than in the control population. Morbidity rates in trans men and controls were similar, with the exception of the increased prevalence of type 2 diabetes.
authors.affiliation: Departments of Endocrinology.
authors.forename: K
authors.initials: K
authors.lastname: Wierckx
authors.forename: E
authors.initials: E
authors.lastname: Elaut
authors.forename: E
authors.initials: E
authors.lastname: Declercq
authors.forename: G
authors.initials: G
authors.lastname: Heylens
authors.forename: G
authors.initials: G
authors.lastname: De Cuypere
authors.forename: Y
authors.initials: Y
authors.lastname: Taes
authors.forename: J M
authors.initials: JM
authors.lastname: Kaufman
authors.forename: G
authors.initials: G
authors.lastname: T'Sjoen
mesh_terms: D000328:Adult; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D016022:Case-Control Studies; D002561:Cerebrovascular Disorders / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D012739:Gonadal Steroid Hormones / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D009203:Myocardial Infarction / Q000453:epidemiology; D009369:Neoplasms / Q000453:epidemiology*; D015995:Prevalence; D011655:Pulmonary Embolism / Q000453:epidemiology; D012307:Risk Factors; D063106:Transgender Persons / Q000706:statistics & numerical data*; D020246:Venous Thrombosis / Q000453:epidemiology
chemical_list: D012739:Gonadal Steroid Hormones