Transgender persons receiving gender-affirming hormone therapy: risk of acute cardiovascular events in a Dutch cohort study
Authors' conclusion
Gender-affirming hormone therapy is not associated with increased cardiovascular risk in transgender women but is in transgender men.
Study context
- Population
- Transgender women and men using gender-affirming hormone therapy 1972–2018 at the Amsterdam gender clinic; diagnoses registered 2012–2022
- Exposure
- Transgender persons using gender-affirming hormone therapy vs general population
- Transgender womenn = 2,714
- Transgender menn = 1,617
- Outcome
- MI, ischaemic cerebrovascular accident and VTE (standardized incidence ratios vs general population, adjusted for socioeconomic status)
Methodological detailssingle-centre (Amsterdam gender clinic), national data registry
- Single-centre (Amsterdam gender clinic)
- National data registry
Main finding
As reported in the abstract
Standardized incidence ratios adjusted for socioeconomic status
Standardized incidence ratio (CI)
Transgender womenvs General population menMI (lower)
.50(.32; .71)
Transgender womenvs General population mencerebrovascular accident (similar)
.94(.72; 1.19)
Transgender womenvs General population menVTE (higher)
1.81(1.33–2.35)
Transgender menvs General population womenMI (higher)
4.20(2.72–6.01)
Transgender menvs General population womencerebrovascular accident (higher)
1.55(1.01–2.20)
Transgender menvs General population womenVTE (similar)
1.00(.53; 1.61)
Observational data: associations, not effects.
Further findings
Impact of socioeconomic status; lifestyle
- Socioeconomic status minimally impacted these results
- Lifestyle largely resembled the general population
Original publication
Transgender persons receiving gender-affirming hormone therapy: risk of acute cardiovascular events in a Dutch cohort study. Eur Heart J. Published 4 November 2025. doi:10.
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