ArticleEndocrine2026
Heart rate variability in transgender people receiving Gender-Affirming hormone therapy.
Article in Endocrine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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6 authors.
Funding
Abstract
backgroundGender-affirming hormone therapy has shown benefits in alleviating gender-related distress and enhancing overall well-being. However, its effects on cardiovascular health are not yet fully understood. PURPOSE: To evaluate heart rate variability, a preclinical marker of cardiovascular disease, both at rest and during sympathetic nervous system stimulation in transgender people undergoing gender-affirming hormone therapy, compared with healthy cisgender controls matched by age and body mass index.
methodsThe study sample included 26 transgender patients (12 transgender women and 14 transgender men) and 25 cisgender controls (12 cisgender men and 13 cisgender women). All participants underwent a 30-minute electrocardiogram recording to assess heart rate variability under resting conditions and during mental stress test.
resultsCompared with their cisgender counterparts, transgender men exhibited reduced cardiac autonomic modulation of cardiac function during stress. In contrast, transgender women did not show significant differences in heart rate variability when compared to controls.
conclusionThese findings suggest that testosterone therapy may impair autonomic cardiovascular responses in transgender men, particularly under conditions of sympathetic activation, whereas estradiol-based regimens showed no significant impact in transgender women. Further research is needed to determine whether these early changes in cardiac autonomic regulation may predict future cardiovascular events in this population.
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