2 new studies say that transgender hormone replacement is safer than birth control

transgender hormone replacement therapy

A pair of studies published in the journal of the American Association for Clinical Chemistry (AACC), Chemical Chemistry, shows that hormone replacement therapy (HRT) is less of a health risk than taking birth control.

Oddly, the research was presented in the men’s health issue of Clinical Chemistry.

In a press release about the latest issue of their journal, the AACC wrote, “This issue aims not only to address men’s unmet health needs, but also to reduce health disparities by promoting dialogue between the men’s, women’s, and transgender health fields.”

The first study, conducted at the University of Washington in Seattle, looked at the risk of blood clots to those taking estrogen as part of their HRT regime.

The findings found that 2.3 blood clots appeared for each 1,000 person-years. (That is, the number of years multiplied by the number of people undergoing such treatment.)

The number of HRT-related blood clots was found to be lower to those occurring in premenopausal women taking birth control: Those women face blood clots at a rate of 3.5 clots per 1,000 person-years.

Dina N. Greene, PhD, the lead researcher on the first study, wrote, “Our data support the risk of thrombotic events (blood clots developing within the human circulatory system) in transgender women taking estrogen therapy being roughly comparable to the risk of thrombotic risks associated with oral contraceptives in premenopausal women.”

Greene continued, “Given the widespread use of oral contraception, this level of risk appears to be broadly accepted.”

Put another way: HRT is nearly as safe as taking birth control medications or more so, at least when it comes to forming blood clots.

However, it’s important to point out: The numbers in both categories remain elevated compared to the general population. Blood clots occur, per average, between 1.0 to 1.8 of the time per 1,000 person-years.

The second study helped backed up the results of the first. It found that transgender men and transgender women who have undergone HRT for over 10 years haven’t had any increase in cardiovascular disease.

Past studies had indicated that trans women could face an increased risk, but was mainly due to the use of ethinyl estradiol, an estrogen medication which is no longer prescribed. 

However, both studies as well as the AACC cautioned about drawing large conclusions about HRT, considering the overall lack of past medical studies the medical field has to work from. The data available is largely inconclusive and we’ll need for larger-scale studies of bigger transgender populations before we can know more about HRT’s long-term effects.

“Only about half of U.S. and Canadian medical schools teach content on gender transition,” the AACC said, “while the National Institutes of Health didn’t add a funding option for transgender research until 2017.”

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