Cardiovascular health in transgender and gender diverse individuals: an expert opinion on gender-affirming hormone therapy, risk assessment and clinical management

Population-level cardiovascular disparities in transgender and gender diverse (TGD) should not be attributed to gender-affirming hormone therapy (GAHT) alone and smoking, obesity, physical inactivity, minority stress, socioeconomic disadvantage, and unequal access to healthcare may independently or interactively influence cardiovascular risk.

Cardiovascular risk assessment in TGD individuals should integrate conventional risk factors, transgender-related cardiovascular risk factors, and patient involvement regarding individual goals.

A coordinated multidisciplinary approach may facilitate personalized cardiovascular prevention while supporting access to gender-affirming care.

Future research should prioritize long-term prospective studies and development of risk prediction models tailored to TGD populations.