Can Patients Safely Continue Estrogen During Gender-Affirming Surgery?

Discontinuing estrogen hormone therapy before gender-affirming surgery is not necessary, according to findings published in the Journal of Clinical Endocrinology and Metabolism.

As estrogen and surgery can both increase thrombotic risk, experts have recommended transgender women stop hormone therapy prior to surgery, but sudden discontinuation of estrogen can cause uncomfortable menopause-like symptoms.

Researchers at the Icahn School of Medicine at Mount Sinai in New York City looked at data on 919 transgender patients undergoing gender-affirming surgery between November 2015 and August 2019, including 407 cases of primary vaginoplasty. No difference in thrombosis was found when estrogen hormone therapy was maintained during surgery.

Of the 919 patients enrolled in the study, one patient who stopped estrogen prior to surgery experienced a venous thromboembolism, the authors noted.

Sources: HealthDay, January 18, 2021; Kozato A, Conner Fox GW, Yong PC, et al. No Venous Thromboembolism Increase Among Transgender Female Patients Remaining on Estrogen for Gender-Affirming Surgery. J Clin Endocrinol Metab. 2021 Jan 8;dgaa966. [Epub ahead of print]