Abstract
Individuals who identify as transgender (TGD) who are taking gender-affirming hormone therapies (GAHT) may experience physiologic changes that impact the interpretation of laboratory results, diagnostic tools, and risk calculations. This review provides guidance for healthcare practitioners on navigating these challenges to ensure appropriate and safe patient care. Key considerations include interpreting standard laboratory results and vital signs, alongside recommendations for preventative cancer screening and cardiovascular risk assessments. Additionally, there are some key considerations when using the CHA2DS2-VASc score in TGD patients with atrial fibrillation, as well as when interpreting a QT/QTc interval. Hormone therapies may also influence a patient’s risk of venous thromboembolism (VTE), necessitating vigilant monitoring and avoidance of supraphysiologic hormone levels. Renal function estimations in patients on GAHT require careful consideration, with alternative equations potentially offering more accurate assessments. Finally, pulmonary function testing poses challenges, highlighting the need for gender-affirming approaches in interpretation. Overall, this comprehensive review underscores the importance of individualized care and shared decision-making in TGD healthcare.
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