A community-based study of demographics, medical and psychiatric conditions, and gender dysphoria/incongruence treatment in transgender/gender diverse individuals

Abstract

Background Current understanding about health care in the gender diverse population is limited by the lack of community-based, longitudinal data, especially in the USA. We sought to characterize a community-based cohort of transgender individuals including demographics, gender identities, social characteristics, psychiatric and medical conditions, and medical therapy for gender dysphoria/incongruence. Patients and methods We performed a retrospective chart review of gender diverse residents of Olmsted County, Minnesota, who sought gender-specific healthcare from January 1, 1974, through December 31, 2015, using an infrastructure that links medical records of Olmsted County residents from multiple institutions. Results The number of patients seeking gender-specific healthcare increased from 1 to 2 per 5-year interval during the 1970s–1990s to 41 from 2011 to 2015 (n = 82). Forty-nine (59.8%) were assigned male sex at birth (AMAB), 31 (37.8%) were assigned female (AFAB), and 2 (2.4%) were intersex. Gender identities evolved over time in 16.3% and 16.1% of patients AMAB and AFAB, respectively, and at most recent follow-up, 8.2% and 12.9% of patients AMAB and AFAB, respectively, were non-binary. Depression affected 78%, followed by anxiety (62.2%), personality disorder (22%), and post-traumatic stress disorder (14.6%). 58.5% experienced suicidal ideation, 22% attempted suicide, and 36.6% were victims of abuse. The most prevalent medical conditions and cardiovascular (CV) risk factors included obesity (42.7%), tobacco use (40.2%), fracture [34.1% (86.2% traumatic)], hypertension (25.6%), hyperlipidemia (25.6%), and hypertriglyceridemia (15.9%). 67.3% of patients AMAB used feminizing and 48.4% of patients AFAB used masculinizing hormone therapy. When compared to US CDC National Health Statistics, there was a significantly greater prevalence of depression and anxiety but no difference in the prevalence of obesity, hypertension, hypercholesterolemia, type 2 diabetes, or stroke. Conclusion Transgender and gender diverse individuals represent a population who express various gender identities and are seeking gender-specific healthcare at increasing rates. Psychiatric illness is highly prevalent compared to the US population but there is no difference in the prevalence of CV risk factors including obesity, type 2 diabetes, hypertension, and dyslipidemia.

Higher risk – less data: A systematic review and meta-analysis on the role of sex and gender in trauma research

“…Although there is increasing evidence that non-binary, trans and gender-diverse persons are disproportionately affected by trauma and adverse health outcomes (Brewerton et al, 2022;Newcomb et al, 2020), none of the studies included in our initial literature search that investigated gender beyond the binary (e.g. Hao et al, 2021;James et al, 2020) fulfilled our methodologically demanding inclusion criteria with regards to study design. Future research should adopt more inclusive assessments of sex and gender (Cameron & Stinson, 2019;Logie et al, 2022).…”

Nursing Care Offered to A Teenager at Risk of Gender Dysphoria and Suicide: A Community Mental Health and Public Health Nursing Approach

“…After that, the interventions administered during the six-month follow-up period of the case were presented together with the literature: Intervention for mental disorder: In studies on gender dysphoria, the prevalence of mental disorders,major depression and anxiety disorders, in particularwas found to be higher than in the general population (Nuttbrock et al, 2010). In a study on gender dysphoria, it was found that young people experience depression and anxiety (James et al, 2020). It has been stated that the history of suicide in transsexual people is 30% or more (Nuttbrock et al, 2010).…”

Dilemas éticos relacionados con la supresión de la pubertad

“…El uso de agonistas gnrh con el propósito de suprimir la pubertad endógena y, así evitar el desarrollo de caracteres sexuales secundarias no deseados, es una estrategia relativamente nueva en el enfoque para tratar niños con disforia de género. Iniciada principalmente por un equipo de especialistas en género en los Países Bajos, la supresión de la pubertad es un recurso cada vez más usado en muchas clínicas de género en todo el mundo (22). El objetivo clínico es disminuir la ansiedad que provocan los cambios propios de la pubertad y, dar más tiempo para conocer su propio género (23).…”

“…El efecto buscado de aliviar la ansiedad de esos niños se lograría con el apoyo de los profesionales de salud mental y de otras especialidades. De hecho, el apoyo de orientadores y consejeros a quienes sufren esta situación está ampliamente recomendado (31). • La escasa edad del paciente para consentir en un tema que puede afectar al resto de su vida (32).…”