Hormone therapy is one of the cornerstones of gender-affirming treatment in people with gender incongruence, but many questions remain open about its medium- and long-term effects on health. A team from Istanbul University-Cerrahpaşa (Turkey) has just published in the journal Endocrine a cross-sectional study analyzing how different cardiometabolic markers behave in transgender men receiving gender-affirming hormone therapy—that is, treatment with testosterone.
The research involved 73 participants: 43 transgender men on hormonal treatment, 15 cisgender men, and 15 cisgender women. In each person, parameters such as glucose, the lipid profile (cholesterol and triglycerides), and total testosterone levels were measured, and from these data two indices widely used in clinical practice to estimate cardiovascular risk were calculated: the atherogenic index of plasma and the visceral adiposity index.
The results showed significant differences between groups. Transgender men presented neck circumference, waist-to-hip ratio, and waist-to-height ratio that were statistically greater than those of cisgender women. In addition, their atherogenic index of plasma was also higher than that of cisgender women. Overall, their cardiometabolic profile more closely resembled that of cisgender men than that of cisgender women, something consistent with the action of testosterone on metabolism.
The authors, however, urge caution when interpreting these data. This is a cross-sectional study—that is, a snapshot taken at a single point in time—and therefore it does not allow establishing a cause-and-effect relationship between hormone therapy and the observed changes. The differences should be read as descriptive and not as evidence of greater cardiovascular risk, although they do highlight the reduction in HDL cholesterol levels (the so-called "good cholesterol") as a point of clinical interest that deserves follow-up.
In short, the work provides valuable evidence for the medical follow-up of transgender people on hormonal treatment and recalls the need to monitor metabolic markers over time. The researchers themselves stress that longitudinal studies, which follow the same patients for years, are needed to clarify the long-term cardiometabolic effects of gender-affirming hormone therapy.
Bibliographic reference:
Muradov I, Uysal S, Kocaman BB, Soltanova L, Karali O, Karaca E, Turan S, Kadioglu P, Durcan E. Cross-sectional comparison of cardiometabolic markers in transgender men receiving gender-affirming hormone therapy. Endocrine. 2026;91(1):221. DOI: 10.1007/s12020-026-04706-4. PMID: 42430065.
View the publication: https://doi.org/10.1007/s12020-026-04706-4
