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Comment by lockhouse | Hacker News Reader

I’m curious if hormonal transgender treatments will have similar long term effects.

It probably will yes. But it’s also measured against the heavily increased suicide risk of trans people who aren’t able to transition.

A large part of the risk can be mitigated by the fact that trans HRT uses bioidentical hormones and that you change the delivery route to transdermal or injections. The risk was substantial 30-40 years ago when trans HRT also used syntehtic hormones, but seemed to have leveled out to near nothing now.

Varying levels (big spikes, big valleys) are an issue too, but very few people are interested in doing anything about it. I'd love to be offered polyestradiol phosphate for instance. But such drugs are very rarely offered to anyone trans, because even after years of HRT, I could suddenly want to detransition and then this lasts too long. Or something.

It’s already suspected though not proven (as far as I know) that estradiol increases breast cancer risk, but I imagine most of that is because it encourages significant breast tissue growth.

If I remember correctly this is at high dosages, so it should be much safer in a normal dosage used for hrt.

HRT as applied to gender dysphoria in transgender women absolutely causes breast tissue growth. That is one of the desired effects. Seeing as 99% of breast cancers occur in women, and HRT causes the patient to have very female like breasts, it would be surprising if the patient did not see an increased risk of breast cancer compared to not taking HRT. Weather or not their risk is higher than the baseline risk for women is less obvious.

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