Wolfgang Miesbach: Individualized Hemostasis Care for Gender-Diverse Patients
Wolfgang Miesbach, Professor of Medicine at Frankfurt University Hospital, shared a post on LinkedIn:
”Gender diversity is no longer a niche topic in hemostasis care but part of everyday clinical reality.
At EAHAD2026, Nathan Connell presented ‘Gender diversity in haemostasis care: bridging gaps in an evolving landscape‘ and highlighted how gender‑affirming hormone therapy and surgeries intersect with venous thromboembolism (VTE) and bleeding risk. Current VTE risk scores do not account for gender‑affirming hormone therapy, yet simply withholding estrogen or testosterone out of fear of clots can cause substantial harm.
For clinical practice, this means moving towards truly individualized care: considering hormone formulation (oral vs transdermal), dose, route, duration, age, co‑morbidities, thrombophilia and co‑existing bleeding disorders, as well as peri‑operative management for gender‑affirming surgeries (e.g. mastectomy, hysterectomy, metoidioplasty, phalloplasty, facial feminization, breast augmentation, orchiectomy, vaginoplasty, vulvoplasty).
We need better data collection, reflection on unconscious bias in multidisciplinary teams, and research agendas built in partnership with the communities we serve.”
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