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: Tobacco use can interfere with estrogen therapy. It is known to potentially lower the effectiveness of oral estrogen and significantly increase the risk of dangerous blood clots.

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Overview of feminizing hormone therapy - UCSF Transgender Care : Tobacco use can interfere with estrogen therapy

: Transgender women on GAHT already face a higher incidence of venous thromboembolism, ischemic stroke, and myocardial infarction compared to cisgender peers; smoking further exacerbates these cardiovascular risks . hot shemale smoking

: Like all smokers, transgender individuals face increased risks of various cancers (lung, mouth, throat), respiratory diseases, and heart disease. Support and Resources

Research indicates that transgender and gender-expansive (TGE) adults are significantly more likely to smoke than cisgender individuals.