Purpose

Many birth-assigned female/transgender male and nonbinary people (identified as masculine spectrum here) begin gender-affirming testosterone therapy by the age of 24 years. Few data inform assessment of cardiovascular health of masculine spectrum youth as a specific subgroup of the 1.5 million transgender people in the United States. The purpose of this review is to help youth-serving practitioners consider, understand, and evaluate cardiovascular health in adolescent and young adult masculine spectrum patients receiving gender-affirming testosterone treatment.

Methods

This is a narrative review intended to synthesize a broad body of clinical and research literature.

Results

Common cardiovascular health changes associated with testosterone include increased red blood cell mass and likely insignificant changes in high-density lipoprotein and low-density lipoprotein levels. Changes in heart mass, heart electrophysiology, and endothelial reactivity are likely, based on extrapolation of data from adults. Testosterone may have indirect effects on cardiovascular health through influences on depression, anxiety, stress, and anorexia nervosa as well as on behaviors such as tobacco use.

Conclusions

Testosterone contributes importantly to the cardiovascular health and well-being of masculine spectrum gender-diverse youth. We need to do a better job of supporting these young people with data on cardiovascular health over the life span.

中文翻译：

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性别肯定睾酮治疗期间青少年的心血管健康：回顾

目的

许多出生指定的女性/跨性别男性和非二元性别的人（此处被确定为男性谱系）在 24 岁时开始进行性别肯定的睾酮治疗。作为美国 150 万跨性别人群中的一个特定亚组，男性谱系青年的心血管健康评估数据很少。本综述的目的是帮助青年服务从业者考虑、理解和评估接受性别确认睾酮治疗的青少年和年轻成年男性谱系患者的心血管健康。

方法

这是一篇旨在综合大量临床和研究文献的叙述性综述。

结果

与睾酮相关的常见心血管健康变化包括红细胞量增加以及高密度脂蛋白和低密度脂蛋白水平可能发生的微不足道的变化。根据对成人数据的推断，心脏质量、心脏电生理学和内皮反应性可能会发生变化。睾酮可能通过影响抑郁、焦虑、压力和神经性厌食症以及吸烟等行为对心血管健康产生间接影响。

结论

睾酮对男性谱系性别多样化青年的心血管健康和福祉有重要贡献。我们需要更好地为这些年轻人提供终生心血管健康数据。