More than a week after my heart attack, I’ve started rereading about the recovery period. I’m mainly looking for guidance on exercise, because I need to get out – being stuck inside is driving me stir-crazy – and I know how much movement helps with anxiety. Exercise has been one way for me to burning off anxiety and stress.

The advice is to work up from five to ten minutes walking maximum this week. Knowing me, I’ll probably sneak up to twelve minutes, just to feel like I’m winning (besides, the maths is easier). A friend has offered to drive me out into the New Forest this week – something beautiful to look forward to. And one day next week I might grab a taxi into town. It has to be a cab, because the buses are more than ten minutes’ walk away – clearly outside the current prescription.

While reading the recovery booklet, I stumbled across a section titled:

Do trans people have a higher risk of heart attack?

Research shows trans people are at higher risk of heart attacks and strokes, but the reason is not clear.

There is some concern about a link between gender-affirming hormone therapy and the risk of heart and circulatory problems. But there’s not enough research in this area to say for sure.

Stigma and stress can be common for trans people, and this can also affect heart and circulatory health.

I bristled at first – because, of course, I don’t want to see myself framed as another medical problem. But reading their words, I couldn’t help but see myself between the lines. I am also concerned that this could be yet another way to block trans care “for our own good”. Patronising buggers.

As a persecuted minority – and I challenge anybody to say that trans people are not persecuted today – we suffer a huge weight of minority stress. The link between stress and heart attacks may not be “proven”, but the correlation is so strong that it feels undeniable.

I don’t believe my heart attack was directly tied to being non-binary. More likely, it’s a messy cocktail: bad genes, relentless emotional stress, and my own neuro-divergence. The British Heart Foundation notes that conditions like depression, anxiety, PTSD, schizophrenia, autism, and epilepsy are all linked with higher risk of heart disease. I know my autism has cost me dearly in relationships, and anxiety has been my unwelcome companion for decades.

Put all that together and the picture is clear enough: my heart may have been ticking down to this for a long time.

So what now? Well, this week it’s twelve minutes’ walking, a taxi instead of a bus, a forest drive if I’m lucky. And more importantly – it’s finding ways to cut stress wherever I can. If my heart is to heal, then managing stress has to be my new cardio.