[elhudy]

Correction: we don't know anything about the long-term physical and mental outcomes for patients on HRT. Modern therapies have only been in use since the early 2000's

I am sorry that this fact upsets you and puts you into a hyper-defensive mode but that does not make it any less of a fact. Here is just one of several real studies confirming this fact with regards to cardio health.

"Gender-affirming or cross-sex hormone therapy is integral to the management of transgender individuals yet our appreciation of the effects of such hormones on cardiovascular health is limited. Insights into vascular pathophysiology and outcomes in transgender people receiving sex steroids could be fundamental in providing better care for this population through the management of cardiovascular risk and more broadly advance our understanding of the role of sex and gender in vascular health and disease. In addition, there is a need to understand how gender-affirming hormone therapy impacts cardiovascular disease risk and events as transgender individuals age...Current research about vascular outcomes in adults receiving hormonal therapy is limited by the absence of large cohort studies, lack of appropriate control populations, and inadequate data acquisition from gender identity services. Existing epidemiological data suggest that the use of estrogens in transgender females confers an increased risk of myocardial infarction and ischemic stroke." [1]

[1]https://pubmed.ncbi.nlm.nih.gov/31656099/