Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Clinical Outlook
  • Published:

Improving the cardiovascular health care of transgender and non-binary persons

Nature Reviews Cardiology volume 20, pages 367–368 (2023)Cite this article

Subjects

Research consistently shows that gender-affirming practices improve markers of cardiovascular health. Consequently, the focus of the management of the cardiovascular health of transgender and non-binary populations should not be on their hormone therapies and surgical histories, but should instead be rooted in the routine screening of cardiovascular risk factors.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Fig. 1: Social determinants of health relevant to the cardiovascular health of the trans population.

References

  1. Streed, C. G. Jr et al. Assessing and addressing cardiovascular health in people who are transgender and gender diverse: a scientific statement from the American Heart Association. Circulation 144, e136–e148 (2021).

    Article  PubMed  PubMed Central  Google Scholar 

  2. Lloyd-Jones, D. M. et al. Life’s essential 8: updating and enhancing the American Heart Association’s construct of cardiovascular health: a presidential advisory from the American Heart Association. Circulation 146, e18–e43 (2022).

    Article  PubMed  Google Scholar 

  3. Arrington-Sanders, R. et al. Assessing and addressing the risk of venous thromboembolism across the spectrum of gender affirming care: a review. Endocr. Pract. 29, 272–278 (2023).

    PubMed  Google Scholar 

  4. Restar, A. et al. Gender affirming hormone therapy dosing behaviors among transgender and nonbinary adults. Humanit. Soc. Sci. Commun. 9, 304 (2022).

    Article  PubMed  PubMed Central  Google Scholar 

  5. Powell-Wiley, T. M. et al. Social determinants of cardiovascular disease. Circ. Res. 130, 782–799 (2022).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Scheim, A. I., Baker, K. E., Restar, A. J. & Sell, R. L. Health and health care among transgender adults in the United States. Annu. Rev. Public Health 43, 503–523 (2022).

    Article  PubMed  Google Scholar 

  7. Tan, K. K. H. et al. Gender minority stress: a critical review. J. Homosex. 67, 1471–1489 (2020).

    Article  PubMed  Google Scholar 

  8. Chen, D. et al. Psychosocial functioning in transgender youth after 2 years of hormones. N. Engl. J. Med. 388, 240–250 (2023).

    Article  CAS  PubMed  Google Scholar 

  9. Ghabrial, M. A. & Andersen, J. P. Identity affirmation is associated with adaptive cardiovascular flexibility in response to stress among sexual and gender minority people of color. Soc. Sci. Med. 320, 115703 (2023).

    Article  PubMed  Google Scholar 

  10. Beach, L. B. & Streed, C. G. Jr. Beyond sex-based medicine in cardiovascular health research and practice. Circulation 147, 529–531 (2023).

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

A.R. is supported by the Research Education Institute for Diverse Scholars (REIDS) Program at Yale University School of Public Health and funded by the National Institute of Mental Health (R25MH087217). C.G.S.Jr acknowledges salary support from a National Heart, Lung, and Blood Institute career development grant (NHLBI 1K01HL151902-01A1), an American Heart Association career development grant (AHA 20CDA35320148), the Doris Duke Charitable Foundation (grant no. 2022061), and the Boston University Chobanian and Avedisian School of Medicine Department of Medicine Career Investment Award.

Author information

Authors and Affiliations

  1. Department of Epidemiology, University of Washington School of Public Health, Seattle, WA, USA

    Arjee Restar

  2. Center for Studies in Demography and Ecology, University of Washington School of Public Health, Seattle, WA, USA

    Arjee Restar

  3. Department of Medicine, Section of General Internal Medicine, Boston University School of Medicine, Boston, MA, USA

    Carl G. Streed Jr

  4. GenderCare Center, Boston Medical Center, Boston, MA, USA

    Carl G. Streed Jr

  5. The Fenway Institute, Fenway Health, Boston, MA, USA

    Carl G. Streed Jr

Authors
  1. Arjee Restar
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Carl G. Streed Jr
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Carl G. Streed Jr.

Ethics declarations

Competing interests

C.G.S.Jr has received consulting fees from EverlyWell and the Texas Health Institute. A.R. declares no competing interests.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Restar, A., Streed, C.G. Improving the cardiovascular health care of transgender and non-binary persons. Nat Rev Cardiol 20, 367–368 (2023). https://doi.org/10.1038/s41569-023-00871-5

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41569-023-00871-5

Search

Advanced search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing