Decrease in HDL Observed Among Transgender Male Patients Receiving Gender-Affirming Hormone Therapy

A team of researchers assessed laboratory parameters in patients undergoing gender-affirming hormone therapy.

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A significant reduction in high-density lipoproteins (HDL) has been observed among transgender male patients receiving gender-affirming hormone therapy (GAHT), according to study results presented at the 30th Annual Scientific and Clinical Congress of the American Association of Clinical Endocrinologists (ENVISION 2021).

This retrospective study included 129 transgender individuals aged 18 years and older (median age, 26 years; median body mass index [BMI] 25.46 kg/m2; 62% White, 12% Black, 8% Hispanic, 18% other) who were receiving GAHT at endocrinology practices within the Northwell system in New York. Transgender male patients (53% of the study population) were given testosterone, and transgender female patients (47% of the study population) were given estradiol, as well as other clinically indicated therapies. Measurements of HDL, low-density lipoprotein cholesterol (LDL-C), triglycerides, 25-hydroxyvitamin D, and HbA1c began after GAHT was initiated and continued for 4 years. Change in each parameter over time was assessed using multivariable mixed modeling with adjustments for covariates.

For each year of GAHT, transgender male patients experienced an HDL decrease of 2.5% (P =.03). No other clinically significant changes were noted.

The study researchers concluded that “a significant decrease in HDL was noted in [transgender male patients] on testosterone therapy,” and that “no other changes [were] noted in cardiovascular parameters.” The study researchers noted that further research is needed on the correlation of these findings with diet and exercise during testosterone therapy.

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Ahmed S, Swe NC, Frenkel M, et al. Cardiometabolic risk factors in transgender individuals taking gender-affirming hormone therapy through four years. Presented at: 2021 AACE Virtual Annual Meeting, May 26-29, 2021.