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Evaluating the Risk of Venous Thromboembolism in Transfeminine and Gender Diverse People: A Retrospective Analysis.
Endocr Pract. 2024 Nov; 30(11):1066-1072.EP

Abstract

OBJECTIVE

The risk of venous thromboembolism (VTE) with feminizing gender-affirming hormone therapy is an area of concern. This analysis aimed to assess whether gender-affirming hormone therapy and other potential risk factors are associated with VTE in transfeminine and gender diverse individuals.

METHODS

We conducted a chart review of 2126 transfeminine and gender diverse adults receiving care within a large urban health system. The primary outcomes were the prevalence of VTE and odds ratios for the association of VTE with insurer, use of estrogen, and select comorbidities.

RESULTS

A history of VTE was documented in 0.8% of the cohort. Those with a history of VTE were older (P < .001), more often self-identified as Hispanic or Black compared to White or Asian (P < .05) and were more likely to have Medicaid or Medicare (P < .01) when compared to those without a history of VTE. The prevalence of hyperlipidemia (P < .001), diabetes mellitus (P < .05), and hypercoagulable conditions (P < .001) were all greater in the positive VTE group. Hyperlipidemia (P < .001), diabetes mellitus (P < .05), and insurer (P < .05) were associated with increased odds of VTE in univariate analyses. None of the exposure variables analyzed were associated with VTE when controlling for age, race, and the number of comorbidities.

CONCLUSIONS

The prevalence of VTE in our cohort was lower than previously observed. VTE was not associated with any one risk factor, including estrogen use, when controlling for age, race, and the number of comorbidities. Those of advanced age and those with multiple cardiometabolic comorbidities may benefit from increased surveillance and mitigation of modifiable risk factors.

Authors+Show Affiliations

Division of Endocrinology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York. Electronic address: djslack01@gmail.com.Icahn School of Medicine at Mount Sinai, New York, New York.Icahn School of Medicine at Mount Sinai, New York, New York.Center for Transgender Medicine and Surgery, Mount Sinai Health System, New York, New York.Division of Endocrinology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York; Center for Transgender Medicine and Surgery, Mount Sinai Health System, New York, New York.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

39233010

Citation

Slack, Daniel J., et al. "Evaluating the Risk of Venous Thromboembolism in Transfeminine and Gender Diverse People: a Retrospective Analysis." Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists, vol. 30, no. 11, 2024, pp. 1066-1072.
Slack DJ, Krishnamurthy N, Chen D, et al. Evaluating the Risk of Venous Thromboembolism in Transfeminine and Gender Diverse People: A Retrospective Analysis. Endocr Pract. 2024;30(11):1066-1072.
Slack, D. J., Krishnamurthy, N., Chen, D., Contreras-Castro, F. G., & Safer, J. D. (2024). Evaluating the Risk of Venous Thromboembolism in Transfeminine and Gender Diverse People: A Retrospective Analysis. Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists, 30(11), 1066-1072. https://doi.org/10.1016/j.eprac.2024.08.014
Slack DJ, et al. Evaluating the Risk of Venous Thromboembolism in Transfeminine and Gender Diverse People: a Retrospective Analysis. Endocr Pract. 2024;30(11):1066-1072. PubMed PMID: 39233010.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Evaluating the Risk of Venous Thromboembolism in Transfeminine and Gender Diverse People: A Retrospective Analysis. AU - Slack,Daniel J, AU - Krishnamurthy,Nithya, AU - Chen,Derek, AU - Contreras-Castro,Felix G, AU - Safer,Joshua D, Y1 - 2024/09/02/ PY - 2024/05/21/received PY - 2024/08/02/revised PY - 2024/08/05/accepted PY - 2024/11/4/medline PY - 2024/9/5/pubmed PY - 2024/9/5/entrez KW - estrogen KW - gender diverse KW - gender-affirming hormone therapy KW - transfeminine KW - transgender KW - venous thromboembolism SP - 1066 EP - 1072 JF - Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists JO - Endocr Pract VL - 30 IS - 11 N2 - OBJECTIVE: The risk of venous thromboembolism (VTE) with feminizing gender-affirming hormone therapy is an area of concern. This analysis aimed to assess whether gender-affirming hormone therapy and other potential risk factors are associated with VTE in transfeminine and gender diverse individuals. METHODS: We conducted a chart review of 2126 transfeminine and gender diverse adults receiving care within a large urban health system. The primary outcomes were the prevalence of VTE and odds ratios for the association of VTE with insurer, use of estrogen, and select comorbidities. RESULTS: A history of VTE was documented in 0.8% of the cohort. Those with a history of VTE were older (P < .001), more often self-identified as Hispanic or Black compared to White or Asian (P < .05) and were more likely to have Medicaid or Medicare (P < .01) when compared to those without a history of VTE. The prevalence of hyperlipidemia (P < .001), diabetes mellitus (P < .05), and hypercoagulable conditions (P < .001) were all greater in the positive VTE group. Hyperlipidemia (P < .001), diabetes mellitus (P < .05), and insurer (P < .05) were associated with increased odds of VTE in univariate analyses. None of the exposure variables analyzed were associated with VTE when controlling for age, race, and the number of comorbidities. CONCLUSIONS: The prevalence of VTE in our cohort was lower than previously observed. VTE was not associated with any one risk factor, including estrogen use, when controlling for age, race, and the number of comorbidities. Those of advanced age and those with multiple cardiometabolic comorbidities may benefit from increased surveillance and mitigation of modifiable risk factors. SN - 1530-891X UR - https://www.unboundmedicine.com/medline/citation/39233010/ DB - PRIME DP - Unbound Medicine ER -