Risk of venous thromboembolism in the transgender population on hormone therapy: A systematic review

Abstract

Background and objective: Hormone therapy is associated with an increased thrombotic risk. The objective of this systematic review is to assess the incidence of venous thromboembolism in the transgender population undergoing gender-affirming hormone therapy and compare it with that in cisgender individuals of the same sex assigned at birth.

Materials and method: A literature search was conducted in databases including PubMed, Cochrane Library, Scopus, and EMBASE, encompassing all studies that report data related to the incidence of venous thromboembolism in transgender individuals on hormone therapy.

Results: Twenty-one studies were included. Five studies assessed the incidence of thromboembolic events in both populations. The occurrence of thrombosis was higher in transgender women than cisgender men (OR: 2.23; 95%CI: 1.93-2.57; P<.001). No differences between transgender men and cisgender women (OR: 0.96; 95%CI: 0.87-2.31; P=.60) were found.

Conclusion: Our systematic review suggests that hormone therapy in transgender women may increase the risk of venous thromboembolism.

Keywords: Gender identity; Gender-affirming hormone therapy; Identidad de género; Medicina transgénero; Revisión sistemática; Sex assigned at birth; Sexo asignado al nacer; Systematic review; Terapia hormonal de afirmación de género; Transexualidad; Transgender medicine; Transsexuality; Tromboembolia venosa; Venous thromboembolism.