According to Martin den Heijer- professor at Amsterdam UMC “Gender-affirming hormone treatment is thought to be safe, and most causes of death in the cohort were not related to this. However, as there is insufficient evidence at present to determine their long-term safety, more research is needed to fully establish whether they in any way affect mortality risk for transgender people.”
The study was conducted on 4,568 transgender people (2,927 transgender women and 1,641 transgender men) who were receiving gender-affirming hormone treatment. The data was collected based on age, type of treatment, smoking habits and medical history. The average age to start the hormone treatment was 30 years in transgender women and 23 years in transgender men.
The mortality risk was double among transgender women compared to men in general Dutch population and three times greater compared to cis women. The cause of death in transgender women was because of cardiovascular disease (2.6%), lung cancer (3.1%), and HIV infection (8.7%).The mortality risk in transgender men was similar to cis men but twice higher compared to cis women.
“We found that most suicides and deaths related to HIV occurred in the first decades we studied, suggesting that greater social acceptance and access to support, and improved treatments for HIV, may have played an important role in reducing deaths related to these causes among transgender people in recent years. It was surprising that mortality risk was higher in transgender people who started gender-affirming hormone treatment in the past two decades, but this may be due to changes in clinical practice. In the past, health care providers were reluctant to provide hormone treatment to people with a history of co morbidities such as cardiovascular disease. However, because of the many benefits of enabling people to access hormone therapy, nowadays this rarely results in treatment being denied.” Says christle de blok.
There were few limitations for the study
The cause of death were documented well but other factors that contribute to mortality was not recorded
Analysis on transgender youth was not possible as they started the hormone therapy at different stages of puberty and at different ages.
The study focused on transgender people who received treatment in Netherlands and more than 90% were white.
The mortality rate in transgender people can be decreased by increasing social acceptance, proper treatment and monitoring for cardiovascular disease, tobacco use and HIV.