Smoking and Gender Affirming Treatments: What You Need to Know

At Thorne Harbour Health, we’re here to support you in making informed decisions without judgment. We know that for our LGBTQ+ communities, smoking, drinking and taking drugs can often be different for us than our cisgender and heterosexual counterparts. Our website Touchbase explains all about this.

We know that LGBTQ+ people smoke at higher rates, so if you’re trying to quit or cut down, that’s fantastic. And if quitting feels out of reach right now, that’s okay too. Either way, knowing the facts can help you stay safer and healthier.

If You’re Taking Estrogen:

• Smoking can make it harder for your body to absorb estrogen, especially if you’re taking it as a pill.
• Using estrogen patches or gels might be better if you’re still smoking or cutting down.
• Smoking while on estrogen increases the risk of serious health issues like blood clots, heart disease, and stroke.
• Quitting is the best way to lower those risks, but every cigarette you skip is a win for your health.

If You’re Taking Testosterone:

• Testosterone therapy can increase the number of red blood cells in your body, and smoking makes this effect much worse. Too many red blood cells can thicken your blood, making it harder to circulate and raising your risk of blood clots.
• Smoking and testosterone together can also increase your risk of heart disease and stroke,—even if your testosterone levels are stable.
• Cutting back or quitting helps reduce these risks over time.

Planning for Gender Affirming Surgery?

If surgery is on the horizon, it’s good to know that smoking can slow down healing and increase the chance of complications. Smoking increases the risk of complications during and after surgery. Whether you’re planning for top or bottom surgery, including both feminising and masculinising surgeries, smoking makes complications more likey:

• Slows wound healing, which can lead to further complications like hematomas (if you’re undergoing top surgery).
• Increases chance of infections.
• Raises the risk of heart and lung problems under anaesthesia.

Some surgeons may ask you to quit before surgery because smoking affects blood flow and your body’s ability to heal properly.

The earlier you can quit or cut back before surgery, the better your recovery will likely be. But if quitting feels tough, chat to your doctor about nicotine replacement options or reach out to Quitline. You can also find out more about how Quitline supports LGBTIQA+ people here.

Want to Quit or Cut Down?

We get it—quitting smoking is hard, and it doesn’t always happen overnight. But every cigarette you skip is a step toward better health and safer outcomes if you’re undergoing gender affirming care.

Need support?

• Call Quitline on 13 7848.
• Reach out to us at Thorne Harbour Health for help with smoking, alcohol, or other drugs. We now offer free nicotine replacements, like patches and gum.

However you choose to move forward, know that we’re here with you, supporting your health, your choices, and your journey.