im pretty sure transitioning doesn’t affect that

Do you have a source for this?

There is one set of heart attack symptoms, but what differs between male and female populations is their relative incidence. For example, (cis*) women are over 2x as likely to experience pain between the shoulder blades, compared to (cis*) men, and ~33% more likely to experience shortness of breath.

HRT, as part of transitioning, impacts both cardiovascular physiology and pain processing, to become more aligned with the person’s gender. This is of course dependent on the duration of treatment, and also on hormone levels actually being within the healthy range for males/females. Whether “more aligned” means “fully aligned” or just “closer to” is an open question and likely also depends on the specific metric. Whether there are sex-based factors that impact cardiovascular physiology and symptom presentation, that do not respond to hormonal treatment in transitioning adults , also needs further research. There are obvious conclusions to be drawn from the fact that feminising HRT in adulthood does not shrink bones to a more ‘typical’ female build for example, but at that point we’d really be talking about the impact of bone size & stature on cardiovascular health, rather than sex necessarily.

(And then, of course, we have some populations who started transitioning before completing the puberty associated with their natal sex, or who were fortunate enough to be put on puberty blockers before transitioning and so never went through the ‘wrong’ puberty.)

*: research around heart attack symptoms in men vs. women, like most medical research, has historically used data from cisgender patients

Definatley an interesting field to talk about I think, and one most people aren’t educated enough in.

Absolutely! I found this meta study on the topic, although the main conclusion is that the studies it covers have various limitations be it in sample size, consistency of the inclusion criteria (some include nonmedical transitioners for example…), or simply the fact that trans populations experience minority stress and socioeconomic differences that have measurable impacts on health. tl;dr way more research needs doing.