Ravi K. Gupta: Hematologic Care and Venous Thromboembolism Management for Transgender Patients
Ravi K. Gupta, House Staff Fellow- Stem Cell Transplantation and Cellular Therapy at UT MD Anderson, shared a post on LinkedIn about a recent article by Nathan T. Connell and Rubén Berrueco Moreno, published in Blood Advances, adding:
“I just read this commentary in Blood Advances by Nathan Connell and Rubén Berrueco Moreno on hematologic care for transgender and gender-diverse people.
It discusses the scoping review by Sandre, Joshi, Pai and Bates.
What stood out: of 31 included articles, 25 looked at physiologic risk, but only 6 examined patient experience.
We’ve studied the complications far more than the relationships and systems needed to manage them.
As an oncologist, I related to these 3 points:
1. Trust is a patient-safety issue.
- If patients fear stigma when disclosing hormone use, we lose information that matters for anticoagulation, bleeding and procedures.
2. Reference intervals matter.
- Testosterone raises hemoglobin and hematocrit. Using the wrong range can label an expected change as disease and trigger unnecessary phlebotomy or hormone interruption.
3. Risk management shouldn’t default to withdrawing gender-affirming care.
After a VTE, the conversation can weigh formulation, route and shared decision-making rather than a simple ‘safe or unsafe.’
This matters for oncology too.
Many of our patients face thrombosis risk, anemia work-ups and treatment decisions where hormone exposure and lab interpretation count.
Small fixes help: correct names and pronouns in the EHR, labs that state which reference interval was used, and clearer referral pathways between hematology, oncology and gender-affirming care.
The authors also call for more prospective and implementation studies.
That’s a research gap worth filling.
Thank you to Nathan Connell, Rubén Berrueco Moreno, Anthony Sandre, Spruha Joshi, Menaka Pai and Shannon Bates for pushing the field here.”
Title: Hematologic care for transgender and gender-diverse people
Authors: Nathan T. Connell, Rubén Berrueco Moreno
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