Table 3.

Representative studies on VTE in patients on testosterone based GAHT

StudyPatient demographicsStudy type and interventionResultsConclusions
Mullins et al (2021)48  611 adolescents and young adults on GAHT; median age  =  17 at initiation of therapy; 68.1% were on testosterone GAHT; N  =   611 Retrospective chart review of patients already on testosterone, primarily IM and SQ formulations; treatment was titrated to physiological normal No incidental occurrence of arterial or venous thrombosis associated with GAHT was found. Multiple thrombotic risk factors were noted among the cohort, including obesity, tobacco use, and personal and family history of thrombosis. 
Oakes et al (2021)49  Transgender and nonbinary individuals receiving testosterone GAHT; N  =   519 The group performed a retrospective study of patients receiving any form of exogenous testosterone; 90% of patients received IM or SQ formulation. Thromboembolic events occurred in 5/519 patients (2 superficial vein thromboses, 2 calf vein thromboses, 1 ischemic stroke). Four of these patients met criteria for erythrocytosis at any time during their care, but none met criteria during the event. Two events occurred after surgery, and 2 patients had predisposing risk factors, including tobacco use and recent trAUma. While 5/519 patients experienced thromboembolic events, none had polycythemia at the time of the event, and the majority had predisposing risk factors. 
StudyPatient demographicsStudy type and interventionResultsConclusions
Mullins et al (2021)48  611 adolescents and young adults on GAHT; median age  =  17 at initiation of therapy; 68.1% were on testosterone GAHT; N  =   611 Retrospective chart review of patients already on testosterone, primarily IM and SQ formulations; treatment was titrated to physiological normal No incidental occurrence of arterial or venous thrombosis associated with GAHT was found. Multiple thrombotic risk factors were noted among the cohort, including obesity, tobacco use, and personal and family history of thrombosis. 
Oakes et al (2021)49  Transgender and nonbinary individuals receiving testosterone GAHT; N  =   519 The group performed a retrospective study of patients receiving any form of exogenous testosterone; 90% of patients received IM or SQ formulation. Thromboembolic events occurred in 5/519 patients (2 superficial vein thromboses, 2 calf vein thromboses, 1 ischemic stroke). Four of these patients met criteria for erythrocytosis at any time during their care, but none met criteria during the event. Two events occurred after surgery, and 2 patients had predisposing risk factors, including tobacco use and recent trAUma. While 5/519 patients experienced thromboembolic events, none had polycythemia at the time of the event, and the majority had predisposing risk factors. 

GAHT, gender affirming hormone therapy; IM, intramuscular; SQ, subcutaneous.

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