In the Journals Plus

Initiating HT may prompt transgender women to quit smoking

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October 11, 2016

Transgender women may be more likely than transgender men or the general population to quit or decrease smoking when initiating hormone therapy, study data show.

“A major concern of physicians beginning to provide hormone treatment for transgender patients is that the hormone treatment may carry risk,” Joshua D. Safer, MD, FACP, of the Center for Transgender Medicine and Surgery and section of endocrinology, diabetes and nutrition at Boston Medical Center and Boston University School of Medicine, told Endocrine Today. “Although studies to date are small, data suggest that if there is risk from hormone treatment, it is small. The benefit of bringing transgender patients into conventional institutions for care is not well studied. In this simple evaluation, the benefit of such care for one endpoint, smoking cessation, is demonstrated to be very significant — far outweighing any anticipated risk from the HT.”

Joshua D. Safer, MD
Joshua D. Safer

Safer and Steven C. Myers, BA, also of the Center for Transgender Medicine and Surgery and section of endocrinology, diabetes and nutrition at Boston Medical Center and Boston University School of Medicine, evaluated 91 transgender women (median age, 51 years) and 30 transgender men (median age, 34 years) to determine whether HT initiation along with counseling for smoking cessation is effective for transgender women.

Smoking data available for transgender women revealed that 43% had a current or previous smoking history; of those, 28% quit before initiating HT and 72% were current smokers when they began the study. During the course of treatment, 64% of transgender women who entered the study as smokers quit and 36% continued smoking.

Smoking data available for transgender men revealed that 15 had been smokers at some point, and seven quit before initiating HT. During treatment, two of the transgender men quit smoking.

“Fear among medical providers of potential risk from HT is a barrier to care for transgender individuals,” Safer told Endocrine Today. “The study demonstrates that the benefit of conventional medical care for transgender individuals can be huge. Providers should recognize the enormous potential benefit and feel more comfortable accepting a modest risk from the HT. Larger studies are needed to determine if there is actual risk from HT. In addition, studies should be designed to measure the benefits of transgender medical care also.” – by Amber Cox

Disclosure: The researchers report no relevant financial disclosures.