June 18, 2026
2 min watch
In a Healio video exclusive, Edward V. Loftus Jr., MD, discusses lingering questions on the potential risks that gender-affirming hormone therapy may have for transgender patients with inflammatory bowel disease.
“There are a lot of unanswered questions in this field,” Loftus, the Maxine and Jack Zarrow Family Professor of Gastroenterology at Mayo Clinic and chief medical editor of Healio Gastroenterology, said. “We have some data that gender-affirming hormone therapy doesn’t appear to increase the risk of IBD flares in transgender individuals.”
In their 2023 retrospective multicenter study published in Clinical Gastroenterology and Hepatology, researchers Victor Chedid, MD, MS, and Kira Newman, MD, PhD, found no overall increase in IBD flares in the first year after patients started hormone therapy.
However, their findings did highlight one crucial caveat: Patients with IBD who began hormone therapy with active disease or ongoing inflammation were more likely to experience a flare in the year that followed.
Clinicians should also consider the risk for venous thromboembolism in patients with IBD receiving hormone therapy. Oral estradiol is known to increase VTE risk, which may be particularly relevant for patients with IBD, who are already at two- to threefold greater risk for VTE than the general population. One “unanswered question” is how overlapping risk factors interact, particularly when hospitalization adds another layer of thrombosis risk to the mix.
“There is the question remaining about thromboembolism risk that needs to be further addressed,” Loftus said. “There might be a role for temporarily stopping such therapy in patients with severe inflammation or hospitalization.”
In this month’s issue of Healio Gastroenterology, Chedid, Newman and other experts from Rainbows in Gastro explore the evolving challenges facing transgender patients with IBD as access to gender-affirming hormone therapy comes under increasing political scrutiny. The discussion also highlights critical knowledge gaps about the psychosocial barriers transgender patients encounter in gastrointestinal care and the influence of stigma on patient outcomes.
“The story also brings up the importance of having a welcoming, non-threatening environment for patients,” Loftus said. “Many patients who are transgender have had unpleasant experiences in the health care system so anything that we can do that says, ‘we welcome all people’ is a good thing.”
Sources/Disclosures
Source:
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References:
Disclosures:
Loftus reports consulting for AbbVie, Alvotech, Amgen, Boehringer Ingelheim, Bristol Myers Squibb, Celltrion Healthcare, Eli Lilly & Co., Fresenius Kabi, Gilead Sciences, Janssen and Takeda, and receiving research support from AbbVie, Bristol Myers Squibb, Celgene/Receptos, Gilead, Janssen and Takeda.
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