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Hormone Therapy for Transgender Women Not Linked to Higher Diabetes Risk

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Hormone Therapy for Transgender Women Not Linked to Higher Diabetes Risk

Transgender women (those assigned male at birth) face a higher risk for diabetes than cisgender (not transgender) women, but no higher risk than cisgender men, according to a new study published in The Journal of Clinical Endocrinology & Metabolism.

Many transgender people — both women and men — undergo gender-affirming hormone therapy, which is recommended by the Endocrine Society’s clinical practice guidelines for gender dysphoria or gender incongruence. While hormone therapy is considered an essential component of health care for this group, there are concerns that it could also raise the risk for certain health conditions — potentially including metabolic disorders like diabetes — in transgender men or women. This is still a fairly new area of research, so many potential risks of gender-affirming hormone therapy are still being investigated.

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For the latest study, researchers used health records from three different health care systems to compare rates of diabetes in transgender and cisgender women and men. The study group included 2,869 transgender women who were matched with 28,300 cisgender women and 28,258 cisgender men, as well as 2,133 transgender men who were matched with 20,997 cisgender women and 20,964 cisgender men. Data for each participant started between 2006 and 2014, with follow-up lasting through 2016. The researchers looked at both diabetes prevalence — how many people had diabetes — and diabetes incidence, or new cases of diabetes.

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Transgender women at higher risk of diabetes than cisgender women

The researchers found that diabetes was more common in transgender women than in cisgender women, with 1.3 times the overall prevalence and 1.4 times the incidence of new cases during the study period. But compared with cisgender men, transgender women were no more likely to have, or to develop, diabetes. For transgender men, no significant difference was seen in the risk for diabetes compared with either cisgender men or cisgender women. There was also no significant difference in the risk for diabetes seen in gender-diverse persons, or those whose gender identity isn’t simply male or female.

“Although [transgender women] may be at higher risk for [type 2 diabetes] compared with cisgender females, the corresponding difference relative to cisgender males is not discernible,” the researchers concluded. “Moreover, there is little evidence that [type 2 diabetes] occurrence in [transgender women or men] is attributable” to gender-affirming hormone therapy — which should provide some reassurance to transgender people and their health care providers when it comes to evaluating the potential risks of this therapy. Still, more research is needed to look at the long-term diabetes outlook in people who receive this therapy, as well as at other potential long-term risks for common but serious conditions like cancer and cardiovascular disease.

Want to learn more about hormones and diabetes? Read “Diabetes and Menopause,” “Testosterone for Type 2 Diabetes?” and “Hormone Therapy for Menopause Not Linked to Type 2 Diabetes Risk.”

Quinn Phillips

Quinn Phillips

Quinn Phillips on social media

A freelance health writer and editor based in Wisconsin, Phillips has a degree from Harvard University. He is a former Editorial Assistant for Diabetes Self-Management and has years of experience covering diabetes and related health conditions. Phillips writes on a variety of topics, but is especially interested in the intersection of health and public policy.

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