Association between serum testosterone and measures of cardiovascular health among transgender individuals using gender-affirming testosterone therapy: a cross-sectional study

Abstract Background Gender-affirming testosterone therapy (GATT) use may be associated with increased systolic blood pressure (SBP). The association between serum testosterone and cardiovascular health in individuals using GATT is unknown. The objective of this study was to estimate the association...

Full description

Saved in:
Bibliographic Details
Main Authors: Badal S. B. Pattar, Tyrone G. Harrison, Nathalie Saad, Sandra M. Dumanski, A.J. Lowik, Paul E. Ronksley, Dina N. Greene, Cameron T. Whitley, Chantal L. Rytz, Keila Turino Miranda, Lindsay Peace, Amelia M. Newbert, Darlene Y. Sola, Sofia B. Ahmed
Format: Article
Language:English
Published: BMC 2025-06-01
Series:Biology of Sex Differences
Subjects:
Online Access:https://doi.org/10.1186/s13293-025-00726-3
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850114654713413632
author Badal S. B. Pattar
Tyrone G. Harrison
Nathalie Saad
Sandra M. Dumanski
A.J. Lowik
Paul E. Ronksley
Dina N. Greene
Cameron T. Whitley
Chantal L. Rytz
Keila Turino Miranda
Lindsay Peace
Amelia M. Newbert
Darlene Y. Sola
Sofia B. Ahmed
author_facet Badal S. B. Pattar
Tyrone G. Harrison
Nathalie Saad
Sandra M. Dumanski
A.J. Lowik
Paul E. Ronksley
Dina N. Greene
Cameron T. Whitley
Chantal L. Rytz
Keila Turino Miranda
Lindsay Peace
Amelia M. Newbert
Darlene Y. Sola
Sofia B. Ahmed
author_sort Badal S. B. Pattar
collection DOAJ
description Abstract Background Gender-affirming testosterone therapy (GATT) use may be associated with increased systolic blood pressure (SBP). The association between serum testosterone and cardiovascular health in individuals using GATT is unknown. The objective of this study was to estimate the association between serum testosterone and validated measures of cardiovascular health, including SBP and arterial stiffness, in persons assigned female sex at birth using GATT. Methods Healthy participants assigned female sex at birth on a stable GATT regimen for ≥ 4 months were recruited to this community-partnered exploratory cross-sectional study. Exposures of interest were total and free serum testosterone concentration. As our primary outcome, SBP was measured by an automated sphygmomanometer, and carotid-radial pulse wave velocity (PWVcr) and aortic augmentation index (AIx) were used to measure arterial stiffness via applanation tonometry. Results Participants (n = 18, median age 28 years, range: 18, 50) who predominantly self-identified as white (94%) and had been using GATT for a median of 48 months (range: 5, 84) were studied. Resting SBP, PWVcr, and AIx were 113 mmHg (range: 102, 129), 7 m/s (range: 4, 9), and 9% (range: − 10, 23), respectively. Total and free serum testosterone were not significantly associated with SBP or PWVcr. Free, but not total, serum testosterone was positively associated with AIx (p = 0.03). Sensitivity analyses did not modify any results. Conclusions In healthy transgender individuals, serum testosterone concentrations may not be associated with measures of cardiovascular health. However, these results need to be interpreted with caution given the limited sample size.
format Article
id doaj-art-7fb01d1ee17043139812f2fb29d48618
institution OA Journals
issn 2042-6410
language English
publishDate 2025-06-01
publisher BMC
record_format Article
series Biology of Sex Differences
spelling doaj-art-7fb01d1ee17043139812f2fb29d486182025-08-20T02:36:49ZengBMCBiology of Sex Differences2042-64102025-06-0116111010.1186/s13293-025-00726-3Association between serum testosterone and measures of cardiovascular health among transgender individuals using gender-affirming testosterone therapy: a cross-sectional studyBadal S. B. Pattar0Tyrone G. Harrison1Nathalie Saad2Sandra M. Dumanski3A.J. Lowik4Paul E. Ronksley5Dina N. Greene6Cameron T. Whitley7Chantal L. Rytz8Keila Turino Miranda9Lindsay Peace10Amelia M. Newbert11Darlene Y. Sola12Sofia B. Ahmed13Cumming School of Medicine, University of CalgaryCumming School of Medicine, University of CalgaryCumming School of Medicine, University of CalgaryCumming School of Medicine, University of CalgaryDepartment of Sociology, University of LethbridgeCumming School of Medicine, University of CalgaryDepartment of Laboratory Medicine, University of WashingtonDepartment of Sociology, Western Washington UniversityCumming School of Medicine, University of CalgaryCardiovascular Health and Autonomic Regulation Laboratory, Department of Kinesiology and Physical Education, McGill UniversitySkipping Stone FoundationSkipping Stone FoundationCumming School of Medicine, University of CalgaryCumming School of Medicine, University of CalgaryAbstract Background Gender-affirming testosterone therapy (GATT) use may be associated with increased systolic blood pressure (SBP). The association between serum testosterone and cardiovascular health in individuals using GATT is unknown. The objective of this study was to estimate the association between serum testosterone and validated measures of cardiovascular health, including SBP and arterial stiffness, in persons assigned female sex at birth using GATT. Methods Healthy participants assigned female sex at birth on a stable GATT regimen for ≥ 4 months were recruited to this community-partnered exploratory cross-sectional study. Exposures of interest were total and free serum testosterone concentration. As our primary outcome, SBP was measured by an automated sphygmomanometer, and carotid-radial pulse wave velocity (PWVcr) and aortic augmentation index (AIx) were used to measure arterial stiffness via applanation tonometry. Results Participants (n = 18, median age 28 years, range: 18, 50) who predominantly self-identified as white (94%) and had been using GATT for a median of 48 months (range: 5, 84) were studied. Resting SBP, PWVcr, and AIx were 113 mmHg (range: 102, 129), 7 m/s (range: 4, 9), and 9% (range: − 10, 23), respectively. Total and free serum testosterone were not significantly associated with SBP or PWVcr. Free, but not total, serum testosterone was positively associated with AIx (p = 0.03). Sensitivity analyses did not modify any results. Conclusions In healthy transgender individuals, serum testosterone concentrations may not be associated with measures of cardiovascular health. However, these results need to be interpreted with caution given the limited sample size.https://doi.org/10.1186/s13293-025-00726-3TransgenderGender-affirming hormone therapyTestosteroneSerum testosteroneCardiovascular healthBlood pressure
spellingShingle Badal S. B. Pattar
Tyrone G. Harrison
Nathalie Saad
Sandra M. Dumanski
A.J. Lowik
Paul E. Ronksley
Dina N. Greene
Cameron T. Whitley
Chantal L. Rytz
Keila Turino Miranda
Lindsay Peace
Amelia M. Newbert
Darlene Y. Sola
Sofia B. Ahmed
Association between serum testosterone and measures of cardiovascular health among transgender individuals using gender-affirming testosterone therapy: a cross-sectional study
Biology of Sex Differences
Transgender
Gender-affirming hormone therapy
Testosterone
Serum testosterone
Cardiovascular health
Blood pressure
title Association between serum testosterone and measures of cardiovascular health among transgender individuals using gender-affirming testosterone therapy: a cross-sectional study
title_full Association between serum testosterone and measures of cardiovascular health among transgender individuals using gender-affirming testosterone therapy: a cross-sectional study
title_fullStr Association between serum testosterone and measures of cardiovascular health among transgender individuals using gender-affirming testosterone therapy: a cross-sectional study
title_full_unstemmed Association between serum testosterone and measures of cardiovascular health among transgender individuals using gender-affirming testosterone therapy: a cross-sectional study
title_short Association between serum testosterone and measures of cardiovascular health among transgender individuals using gender-affirming testosterone therapy: a cross-sectional study
title_sort association between serum testosterone and measures of cardiovascular health among transgender individuals using gender affirming testosterone therapy a cross sectional study
topic Transgender
Gender-affirming hormone therapy
Testosterone
Serum testosterone
Cardiovascular health
Blood pressure
url https://doi.org/10.1186/s13293-025-00726-3
work_keys_str_mv AT badalsbpattar associationbetweenserumtestosteroneandmeasuresofcardiovascularhealthamongtransgenderindividualsusinggenderaffirmingtestosteronetherapyacrosssectionalstudy
AT tyronegharrison associationbetweenserumtestosteroneandmeasuresofcardiovascularhealthamongtransgenderindividualsusinggenderaffirmingtestosteronetherapyacrosssectionalstudy
AT nathaliesaad associationbetweenserumtestosteroneandmeasuresofcardiovascularhealthamongtransgenderindividualsusinggenderaffirmingtestosteronetherapyacrosssectionalstudy
AT sandramdumanski associationbetweenserumtestosteroneandmeasuresofcardiovascularhealthamongtransgenderindividualsusinggenderaffirmingtestosteronetherapyacrosssectionalstudy
AT ajlowik associationbetweenserumtestosteroneandmeasuresofcardiovascularhealthamongtransgenderindividualsusinggenderaffirmingtestosteronetherapyacrosssectionalstudy
AT pauleronksley associationbetweenserumtestosteroneandmeasuresofcardiovascularhealthamongtransgenderindividualsusinggenderaffirmingtestosteronetherapyacrosssectionalstudy
AT dinangreene associationbetweenserumtestosteroneandmeasuresofcardiovascularhealthamongtransgenderindividualsusinggenderaffirmingtestosteronetherapyacrosssectionalstudy
AT camerontwhitley associationbetweenserumtestosteroneandmeasuresofcardiovascularhealthamongtransgenderindividualsusinggenderaffirmingtestosteronetherapyacrosssectionalstudy
AT chantallrytz associationbetweenserumtestosteroneandmeasuresofcardiovascularhealthamongtransgenderindividualsusinggenderaffirmingtestosteronetherapyacrosssectionalstudy
AT keilaturinomiranda associationbetweenserumtestosteroneandmeasuresofcardiovascularhealthamongtransgenderindividualsusinggenderaffirmingtestosteronetherapyacrosssectionalstudy
AT lindsaypeace associationbetweenserumtestosteroneandmeasuresofcardiovascularhealthamongtransgenderindividualsusinggenderaffirmingtestosteronetherapyacrosssectionalstudy
AT ameliamnewbert associationbetweenserumtestosteroneandmeasuresofcardiovascularhealthamongtransgenderindividualsusinggenderaffirmingtestosteronetherapyacrosssectionalstudy
AT darleneysola associationbetweenserumtestosteroneandmeasuresofcardiovascularhealthamongtransgenderindividualsusinggenderaffirmingtestosteronetherapyacrosssectionalstudy
AT sofiabahmed associationbetweenserumtestosteroneandmeasuresofcardiovascularhealthamongtransgenderindividualsusinggenderaffirmingtestosteronetherapyacrosssectionalstudy