Yes! Study Shows You Can Remain on Estrogen for Gender Affirming Surgery!
No matter how excited you are, It is both emotionally and physically strenuous to go through gender-affirming surgery.
On top of that, many surgeons require lowering or being off feminizing hormones in order to lower the risk of venous thromboembolism (VTE) during surgery.
Resulting in patients struggling with emotional and mood dysregulation and oftentimes increased dysphoria due to a decrease in hormone levels.
Asking patients to lower or stop their hormone regimen potentially puts them in a poor position to emotionally manage any challenges related to upcoming surgery including:
pre-surgery mental preparation
how they feel post-surgery and during recovery
having to juggle surgical outcomes as well as mood regulation off HRT
and managing overall feelings arising from having something as complicated as surgery to being with
During my DR Z PHD Interviews Dr. Kristen Vierregger widely known as Dr. V to the trans community for her amazing medical care in endocrine medicine, we discussed the issue of being off feminizing therapy while going through surgery.
Dr. V made expressed there was no need for medical doctors to ask trans femme patients to lower or completely stop their hormone regimen as recent medical research showed it was not necessary.
The recent study Dr. V cited “No Venous Thromboembolism Increase Among Transgender Female Patients Remaining on Estrogen for Gender-Affirming Surgery” looked at a total of 919 TGNB patients out of which 407 cases were trans feminine patients undergoing primary vaginoplasty.
This study concluded that preoperative venous thromboembolism was not a significant risk for individuals on feminizing hormone therapy.
The additional study “Estrogen Continuation and Venous Thromboembolism in Penile Inversion Vaginoplasty” suggests that preoperative estrogen continuation may be safe for patients specifically undergoing penile inversion vaginoplasty (PIV), due to low baseline VTE risk in patines.
However, it goes on to suggest, “clinicians should weigh the magnitude of the risks and benefits of estrogen cessation on a case-by-case basis.”
It appears there have been numerous studies to support the maintenance of estrogen therapy prior to surgery including a recent study: “Continuing perioperative estrogen therapy does not increase venous thromboembolic events in transgender patients: a systematic review and meta-analysis” concluding perioperative estrogen therapy does not increase VTE risk.
Regardless of numerous studies supporting the safety of remaining on estrogen therapy prior to gender-affirming surgery, it is always important to discuss it with your medical doctor and to consider your personal history.
If however, your doctor is simply uninformed regarding the above-mentioned studies, feel free to print and bring a copy to help them increase awareness and educate themselves.
REFERENCES & SOURCES
J Badreddine, M H Lee, K Mishra, R Pope, J Y Kim, S H Hong, S Gupta, J M Song, J I Shin, R A Ghayda. “Continuing perioperative estrogen therapy does not increase venous thromboembolic events in transgender patients: a systematic review and meta-analysis.”
Aki Kozato, G W Conner Fox, Patrick C Yong, Sangyoon J Shin, Bella K Avanessian, Jess Ting, Yiwei Ling, Subha Karim, Joshua D Safer, John Henry Pang. “No Venous Thromboembolism Increase Among Transgender Female Patients Remaining on Estrogen for Gender-Affirming Surgery.”
Ian T Nolan , Caleb Haley, Shane D Morrison, Christopher J Pannucci, Thomas Satterwhite. “Estrogen Continuation and Venous Thromboembolism in Penile Inversion Vaginoplasty.”