Transgender Health
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Transgender and gender-diverse people have unique health needs shaped by biology, gender identity, and access to affirming care.
Whether you’re beginning gender-affirming treatment, have been on hormone therapy for years, or are supporting someone who is, understanding how these factors affect cardiovascular and overall wellness is key to long-term health.
This hub provides evidence-based information on hormone therapy, preventive care, and mental well-being, along with guidance for finding supportive and knowledgeable clinicians.
Our goal is to help you make informed choices, manage your health with confidence, and access care that aligns with your identity and individual needs.
Transgender health covers all parts of well-being—physical, emotional, and social—with care that recognizes and supports your individual needs. It goes beyond transition-related treatment to support your overall health.
Key priorities in transgender health include:
Access to gender-affirming care and clinicians who understand transgender and gender-diverse needs.
Monitoring for cardiovascular and metabolic changes related to hormone therapy.
Managing stress, including the effects of social and environmental factors on heart and vascular health.
Keeping up with preventive screenings based on your anatomy, age, and hormone use.
Supporting mental health and maintaining community connections.
Affirming care means recognizing that everyone’s health goals and baselines may look different—and that care should meet you where you are.
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How Gender-Affirming Hormone Therapy Affects Heart and Vascular Health
Gender-affirming hormone therapy (GAHT) can be life-saving for many people, but it also changes how the cardiovascular and vascular systems function.
Estrogen therapy (commonly used by transgender women) may slightly increase risks for:
Blood clots (venous thromboembolism)
Stroke or hypertension (especially with oral formulations)
Testosterone therapy (commonly used by transgender men) may lead to:
Higher red blood cell counts (polycythemia)
Changes in cholesterol levels
Mild increases in blood pressure
Practical recommendations:
Work closely with a provider experienced in GAHT
Discuss your personal and family history of vascular disease
Get regular blood pressure, lipid, and clotting factor checks
Report new leg swelling, chest pain, or shortness of breath immediately
The goal is not to discourage hormone therapy—but to ensure safe, informed care through regular monitoring.
Preventive Care and Screening
Preventive care should be based on your anatomy, hormone use, and personal risk factors. Working with a clinician who understands your medical history helps ensure appropriate, timely screening.
Recommended screenings for adults include:
Blood pressure and cholesterol: every 1–2 years, or more often if you have risk factors.
Blood sugar (A1C): if you’re using hormone therapy or have a higher risk of metabolic changes.
Cancer screenings: based on current anatomy (for example, breast/chest, prostate, or cervical screening).
Bone density testing: if you’ve been on long-term hormone therapy or are at risk for osteoporosis.
Sexual health testing: regular STI screening and discussions about safe practices.
Finding supportive care
Look for clinicians and clinics that:
Provide care tailored to your medical history and anatomy.
Communicate clearly and respectfully.
Have experience managing patients using hormone therapy or can collaborate with specialists when needed.
Proactive, individualized care helps identify issues early and supports long-term heart and vascular health.
Mental Health and Minority Stress
Many transgender and gender-diverse people experience unique stressors related to social or healthcare challenges. These pressures can affect both mental well-being and cardiovascular health. Ongoing stress may raise blood pressure, increase vascular inflammation, and make recovery more difficult.
Ways to support emotional and heart health:
Connect with mental-health professionals or peer groups experienced in transgender care.
Practice daily stress-management techniques such as mindfulness, art, or gentle movement.
Maintain a supportive network of friends, family, or online communities.
Speak openly with your care team about any mental-health concerns or symptoms of anxiety or depression.
Caring for mental health benefits the entire body, including the heart and vascular system.
Long-Term Care and Health Coordination
Long-term health requires coordinated care across specialties. Collaboration between endocrinology, primary care, and cardiology helps ensure safe hormone management and early detection of health changes.
How to build your care team
Establish a primary care provider familiar with your medical history and hormone therapy.
Keep all specialists informed about your medications and lab results.
Review blood work at least once a year, or more often when therapy changes.
Maintain copies of your medical records so they can be shared easily between providers.
Health maintenance checklist
Annual physical exams
Blood pressure, cholesterol, and blood sugar monitoring
Medication review and cardiovascular risk assessment
Mental and emotional health check-ins
Coordinated care helps prevent complications and keeps all aspects of your health on track.
Access, Rights, and Care Coordination
Some people encounter challenges when seeking consistent medical care, such as insurance denials or a lack of experienced providers. Knowing your rights and available resources can help you navigate these barriers.
Key protections in the United States
Under Section 1557 of the Affordable Care Act, discrimination in healthcare based on gender identity is prohibited.
Many states and insurers now include coverage for gender-affirming care and hormone therapy.
Patient advocacy organizations can assist with insurance appeals and provider referrals.
Organizations that offer guidance
Understanding your coverage and rights helps you plan care, avoid interruptions, and stay connected to qualified clinicians.
Community and Support
Support from others can make a meaningful difference in maintaining long-term health. Connecting with people who share similar experiences provides encouragement, education, and practical advice.Ways to stay connected:
Join peer-led community groups or virtual networks
Attend local LGBTQ+ health events or wellness workshops
Volunteer or mentor within the community
Share your story to inspire others on similar journeys
Community connection can improve mental well-being, reduce stress, and help you stay engaged in your care over time.
Find Affirming Care and Support
Explore trusted resources, clinics, and programs that support transgender and gender-diverse health. Knowledge and affirming care can improve both health outcomes and quality of life.
References
Deutsch MB et al. (2023). UCSF Guidelines for the Primary and Gender-Affirming Care of Transgender and Gender-Nonbinary People. UCSF Center of Excellence for Transgender Health.
WPATH (2022). Standards of Care for the Health of Transgender and Gender-Diverse People, Version 8. Int J Transgend Health, 23 (S1): S1–S259.
American Heart Association (2023). Cardiovascular Health in Transgender and Gender-Diverse Individuals. Circulation.
GLMA (2023). Best Practices for LGBTQ+ Inclusive Healthcare.