As a trans non-binary femme using HRT (estradiol) and as a person with two advanced degrees and 20 years of practice in study design, I feel the need to share a few words about this study. (1/n) https://twitter.com/jk_rowling/status/1279759022112071680

First of all, after you look at the link that JK Rowling shared, please go look at the original study, "Occurrence of Acute Cardiovascular Events in Transgender Individuals Receiving Hormone Therapy," here https://www.ahajournals.org/doi/full/10.1161/CIRCULATIONAHA.118.038584

The study authors retrospectively compared the rates of acute cardiovascular events between 2517 trans women, 1358 trans men, and "reference" rates among women and men in the general population. And (surprise surprise), they found...

The trans men and trans women had higher rates for cardiovascular events than reference rates among cis men and cis women.

That's it.

That's the study.

The authors note "A limitation of our study is that we could not adjust for potential confounders such as psychosocial stressors and smoking (of which the prevalence was relatively high in our population: 43%–46%) because of our study design."

In other words, this study design doesnt tell you whether other extremely important factors, like the stress of being trans in a cis world, or SMOKING, might explain the high rate of CVEs among trans people.

Probably most important, in this context: the study design DOESN'T compare CVE rates between trans people who use hormones, trans people who don't use hormones, cis people who use hormones, and cis people who don't (!!!) Not even reference comparison.

This study design also most definitely DOESN'T compare CVE rates between trans folks who use hormones and lesbians and gay men who question their gender identity but then through therapy decide they are not trans and don't use hormones.

Since it doesn't do any of these things, even as a retrospective study, it does NOT support the statement that "cross-sex" hormone use is more particularly dangerous than any other hormone use.

In other words, this study is useful because it provides data about how trans people are more likely to suffer cardiovascular events, and to smoke, than cis people.

Yup. The world is indeed hard for trans folks!

Rates of stress related health issues are even higher if you're trans and multiply burdened under the matrix of domination (if you're trans, Black, brown, indigenous, Disabled, working class, and/or immigrant)

To be clear: there are absolutely specific health risks from taking hormones, and no one take them lightly (no one actually does take them lightly, tbh).

But this study does not say what JKR says it says.

One more note: the authors created this study by looking back through clinical records, without the explicit consent of the trans ppl involved. That's what this means: "This study was approved by our local ethical committee, with a waiver for informed consent."

Perhaps the ethical committee should not have waived consent, especially given the harm that may now result.

That's the end of my thread.

Please donate to Black led LGBTQ organizations.

#BlackTransLivesMatter
#JKRowling
#JKR https://www.intheknow.com/2020/06/10/black-lgbtq-organizations-donate/