Although hormone therapy for transgender persons is a key component of gender-affirming care, its long-term effects on heart and blood vessel safety remain largely unanswered. The heart and blood vessels make up the cardiovascular system. The structure and function of this cardiovascular system are known to differ between the sexes. Additionally, sex hormones like estrogen and testosterone influence the heart and blood vessels. The present study investigated whether 10 years of hormone therapy in transgender persons leads to changes in cardiovascular structure and function. Therefore, cardiovascular ultrasound parameters were compared between transgender and cisgender individuals. The present study noted differences in the heart’s structure, pumping ability, filling phase, and arterial stiffness. These findings were different for transgender women than for transgender men. In transgender women, cardiac mass was lower, and pumping function and arterial stiffness were increased. In transgender men, an increase in pumping function and arterial stiffness, and a decrease in cardiac filling phase were observed. Although some differences in cardiovascular parameters in transgender persons have been reported, they do not necessarily result in cardiovascular disease. In addition, other factors than hormone therapy may have played a part in the observed results. Further research is needed to explore this question in more depth.