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Stockholm, Sweden – A new study highlights potential health risks associated with long-term hormone therapy in transgender men, revealing significant changes in body composition and increased cardiovascular risk factors. The findings, published Thursday in the Journal of Internal Medicine, underscore the importance of monitoring long-term health outcomes for individuals undergoing gender-affirming treatments.
Hormone therapy, which helps transgender individuals align their physical characteristics with their gender identity, has been shown to cause substantial physiological changes. Researchers from Karolinska Institutet in Sweden followed 33 transgender adults—17 transgender men treated with testosterone and 16 transgender women treated with estrogen—over six years to understand the impacts of sustained hormone use.
Using magnetic resonance imaging (MRI) scans and blood tests, researchers assessed body composition, blood pressure, and metabolic risk factors at three intervals: before hormone therapy, after one year, and after five to six years.
Key Findings in Transgender Men
The study found that transgender men undergoing testosterone therapy experienced a 21% increase in muscle volume over six years, with the most dramatic changes occurring during the first year of treatment. However, these benefits were accompanied by a 70% rise in abdominal fat and higher levels of liver fat and LDL cholesterol—factors associated with an elevated risk of cardiovascular disease.
“We observed significant changes in muscle mass and fat distribution that could increase the long-term risk of cardiovascular issues,” said Tommy Lundberg, lead researcher from Karolinska’s Department of Laboratory Medicine. “It’s essential to monitor these individuals to mitigate potential health risks.”
Differences in Transgender Women
In contrast, transgender women treated with estrogen displayed smaller changes in body composition. Over five years, their muscle volume decreased by an average of 7%, although muscle strength remained stable. They also gained total body fat but did not experience the same increases in abdominal fat as transgender men.
Implications for Healthcare
While hormone therapy provides essential support for many transgender individuals’ well-being, Lundberg emphasized the need for ongoing research and careful health monitoring.
“Long-term follow-ups are crucial to address any emerging risks, particularly related to cardiovascular health,” Lundberg said.
The study’s findings add to a growing body of evidence informing the care of transgender individuals, helping healthcare providers tailor treatments while minimizing potential risks.
