* This post was inspired by a thought, not a research paper. Sex is a fundamental characteristic in studies of health. On average, men have more heart disease and die at an earlier age than women. I wondered if medical interventions to change sex hormone levels would impact risk rates of heart disease.
* I searched pubmed for “transgender people” and “cardiovascular disease.” I focused on systematic reviews and meta-analyses as the best evidence.
* There were five key papers to review. Between them they captured important aspects of this topic from the size of the transgender population to mortality rates in long studies.
* I compared incident rates for men who took sex hormones and/or blocked male sex hormones with men and also women. I compared incident rates for women who took sex hormones and/or blocked female sex hormones with women and also men.
* Risks were higher for men wanting to be women than vice versa. Risks were higher for those taking hormones than those not taking hormones. Risks were higher for those having surgery than those in the non-trans population. Many of the risk ratios were high – over double – which puts the results in the Bradford Hill possible causation territory.
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