Gender-affirming hormone treatment causes changes of gender phenotype in a 12-lead electrocardiogram.

Abstract Background Men and women have specific patterns in an electrocardiogram (ECG) differentiated by J-point elevation and ST angle. Although gender-affirming hormone treatment is one of the treatments for gender dysphoria, its influence on an ECG has not been clarified yet. Objective To investigate ECG changes induced by gender-affirming hormone treatment. Methods The study population consisted of 29 transgender males and eight transgender females and 37 age- and sex-matched cisgender females and males. Male pattern was defined as J-point elevation > 0.1 mV and ST angle > 20° in precordial leads. Results In the comparison between 29 transgender males and cisgender females, the prevalence of male pattern (89.7% vs. 6.9%, p Conclusion Gender-affirming hormone treatment for gender dysphoria is accompanied by a change in the ECG phenotype towards affirming gender, in which change in androgen level may be involved.