Transgender individuals may be at an increased risk for certain cardiac diseases due to a combination of factors. Hormonal therapy, which is a common part of gender transition for transgender individuals, can lead to changes in lipid levels and blood pressure that increase the risk of cardiovascular disease. Additionally, transgender individuals often experience higher rates of smoking and substance use, which can also contribute to an increased risk of cardiac diseases. One study conducted in 2018 found that transgender women (people assigned male at birth who identify as female) had a higher risk of cardiovascular disease compared to cisgender individuals. The study, which included over 2,500 transgender women, found that transgender women had a 2.7-fold increased risk of myocardial infarction (heart attack) and a 2.3-fold increased risk of stroke compared to cisgender women. The study also found that transgender women had a higher prevalence of hypertension and diabetes, which are both risk factors for cardiovascular disease. Another study conducted in 2020 found that transgender men (people assigned female at birth who identify as male) had a higher risk of hypertension and diabetes compared to cisgender men. The study, which included over 1,200 transgender men, found that transgender men had a 2.5-fold increased risk of hypertension and a 2.3-fold increased risk of diabetes compared to cisgender men. The study also found that transgender men had a higher prevalence of smoking and substance use, which can contribute to an increased risk of cardiovascular disease. Despite these findings, more research is needed to fully understand the link between transgender individuals and cardiac diseases. Many studies in this area have been small and limited in scope, and more research is needed to confirm the findings and to understand the underlying mechanisms that may be contributing to an increased risk of cardiovascular disease in transgender individuals. It is important for healthcare providers to be aware of the potential risks for cardiovascular disease in transgender individuals and to provide appropriate screenings and care. This includes monitoring lipid levels and blood pressure, as well as providing information and support for healthy lifestyle changes, such as quitting smoking and reducing substance use. It is also important to address the stigma and discrimination that transgender individuals may face in healthcare settings, which can lead to poor access to healthcare and ultimately increase the risk of cardiovascular disease. Dr. A. Arrazaghi, MD, FRCPC