Research
Hormonal
Ethinyl estradiol is strongly associated with an increased risk of cardiovascular events and should be avoided in transgender women; oral and transdermal estradiol are preferred.
Transgender women should avoid ethinyl estradiol due to its strong association with blood clots and cardiovascular events. Instead, use oral or transdermal estradiol, which are safer and preferred formulations.
GoodRefutesHIGH confidence
This is no longer the case, as clinical evidence has showed a strong relationship between ethinyl estradiol and the incidence of deep venous thrombosis (13). As a result, there are strong recommendations against the use of ethinyl estradiol in transgender patients (8). ... Use of oral ethinyl estradiol appears to be strongly associated with cardiovascular events (30) and should therefore be avoided as a mainstay therapy for patients (31).
Why this rating
The paper cites strong clinical evidence and recommendations against ethinyl estradiol, contrasting it with preferred formulations.
Source
Hormone therapy for transgender patients
Cécile A. Unger · Translational Andrology and Urology · 2016
DOI 10.21037/tau.2016.09.04
narrative_reviewCited 243×
Read the paper DOI resolved against Crossref · corpus check 2026-06-10
More from this paper
- Cross-sex hormone therapy (testosterone for trans men, estrogen/anti-androgens for trans women) significantly improves quality of life, mood, and reduces perceived stress and cortisol levels.Moderate
- Testosterone therapy in transgender men is effective for virilization, with higher doses achieving effects faster but not resulting in greater final outcomes compared to lower doses over the intermediate term.Moderate
- Long-term cross-sex hormone therapy does not increase the occurrence of cardiovascular events (myocardial infarction, DVT, cerebrovascular events) in transgender men, despite some negative changes in metabolic risk factors.Moderate
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