Cardiovascular disease risk in the transgender population.

This review summarizes the impact of gender affirming hormone therapy used in the transgendered population and the classic and emerging risk factors on cardiovascular outcomes and surrogate markers of cardiovascular health. There is a growing body of evidence that people who are transgender and gender diverse are impacted by disparities across a variety of cardiovascular risk factors compared with their peers who are cisgender. Previously, disparities have been reported in cardiovascular morbidity and mortality across this group as a result of a higher prevalence of non-healthy life style. However, recent research suggests that there are additional factors playing a role in this differences: there is the hypothesis that the excess of cardiovascular morbility and mortality has been driven by psychosocial stressors across the lifespan at multiple levels, as structural violence (e.g., discrimination, lack of affordable housing, lack of access to health care, etc.). Lack of information and research in this population is an important limitation; therefore, a multifaceted approach that integrates best practice into research, health promotion and cardiovascular care for this understudied and growing population is clearly needed.