Venous Thromboembolism in Transgender Individuals Receiving Hormone Replacement Therapy in Alberta, Canada
Notice bibliographique
Résumé
Background: Hormone therapy is a key component of gender-affirming care for transgender individuals. Estrogen, testosterone, and progestin therapy have been associated with a higher risk of venous thromboembolism (VTE). However, this is largely based on use of these medications in hypogonadism, birth control, and hormone replacement therapy (HRT). There is a lack of information regarding their relation to VTE risk in transgender persons. The aim of this study is to retrospectively examine VTE events for transgender individuals in Alberta, Canada, and their potential association with hormone therapy. Methods: Chart review of adult (≥ 18 years of age) transgender individuals was completed using electronic medical records between 2002 and 2021. A list of individuals for the study was provided by a psychiatrist who specializes in transgender care at the Gender Program in Edmonton, Canada. Population included those who were referred for gender affirming surgery. Data collected included age, affirmed gender, VTE events, thrombophilia history, anticoagulation use, and hormone therapy. All data was anonymized prior to analysis. This study was approved by the Alberta Health Ethics Research Board (Pro00114160). Results: Fifty-six individuals were identified for this study. Median age as of December 31, 2021 was 27.5 years (range 18-73). Affirmed gender in this cohort included 36 affirmed females (64%), 13 affirmed males (23%), and 7 non-binary individuals (13%). None of the individuals had a history of thrombotic events prior to the study, nor did any have known genetic or acquired thrombophilia. Two of the affirmed female individuals (ages 69 and 73) were on anticoagulation for atrial fibrillation during the study. There were no VTE events (DVT or PE) documented in this cohort. In terms of HRT, 46 of 56 individuals (82%) were on HRT at some point in the study, including 32/36 affirmed females (89%), 10/13 affirmed males (77%), and 4/7 non-binary individuals (57%). 18/36 of affirmed females (50%) were on combined estradiol and progesterone at some point in the study. Limitations of this study include the small numbers, retrospective nature and incomplete documentation. Furthermore, transgender individuals must go out of province for gender affirming surgery, and documentation around this strong provoking event was not included as was not accessible in this chart review. Conclusion: While there is a known association between hormone supplementation and VTE, there were no documented VTE events in this cohort. Further prospective studies would be ideal to fully characterize other VTE risk factors in this cohort and to monitor for VTE events.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,003 |
| Études des sciences et des technologies | 0,002 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».