Hematology Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
Department of Vascular Medicine, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
J Thromb Haemost. 2019 Nov;17(11):1790-1797. doi: 10.1111/jth.14626. Epub 2019 Sep 13.
The medical care of transgender patients relies on the use of sex hormones to develop and maintain the physical characteristics consistent with gender identity as the first step in transitioning. Hormonal therapy is usually continued indefinitely, even following gender-affirming surgeries. The use of hormonal treatments is associated with a multitude of positive effects as well as complications and side effects. The risk of venous thromboembolism (VTE) is a major concern. Transgender patients are often referred to coagulation specialists for advice regarding an individual patient's risk for VTE, especially if there is a personal or family history of VTE. Coagulation specialists need to be familiar with endocrine therapy including the goals of treatment and the VTE risks associated with currently used hormone regimens. We will review common referral questions and the available data and their limitations for the use of hormonal therapy in transgender patients focusing on the risk of VTE.
transgender 患者的医疗护理依赖于使用性激素来发展和维持与性别认同一致的身体特征，这是过渡的第一步。激素治疗通常会无限期持续，即使在进行性别肯定手术后也是如此。激素治疗的使用与多种积极影响以及并发症和副作用相关。静脉血栓栓塞 (VTE) 的风险是一个主要关注点。 transgender 患者经常被转介给凝血专家，以就个体患者的 VTE 风险提供建议，特别是如果有个人或家族 VTE 病史。凝血专家需要熟悉内分泌治疗，包括治疗目标以及与当前使用的激素方案相关的 VTE 风险。我们将回顾常见的转介问题以及针对 transgender 患者使用激素治疗的现有数据及其局限性，重点关注 VTE 的风险。
