Health and Cardiometabolic Disease in Transgender Adults in the United States: Behavioral Risk Factor Surveillance System 2015

Abstract

ContextLittle is known about the health of transgender adults in the United States, a growing population. There have been no large reports examining differences in health status and cardiometabolic disease in subgroups of transgender adults [female-to-male (FTM), male-to-female (MTF), and gender nonconforming (GNC)] in the United States.ObjectiveCompare the health status and prevalence of cardiometabolic disease among specific subgroups of transgender adults (FTM, MTF, GNC) with those of cisgender adults in the United States.DesignSecondary data analysis based on the 2015 Behavioral Risk Factor Surveillance System survey.SettingThe 22 states in the United States that asked about transgender identity.ParticipantsNoninstitutionalized adults age ≥18 years who reside in the United States, identified through telephone-based methods.Main Outcome MeasuresData were extracted for respondents who answered the transgender identity question. Weighted percentages are given for all measures. Adjusted odds ratios (ORs) are reported for health status and cardiometabolic disease measures.ResultsFTM adults have a higher odds of being uninsured than both cisgender women [OR 3.8; 95% confidence interval (CI), 2.1 to 7.1] and cisgender men (OR 2.5; 95% CI, 1.4 to 4.7). MTF adults have a higher odds of reporting myocardial infarction than cisgender women (OR 2.9; 95% CI, 1.6 to 5.3) but not cisgender men.ConclusionsThere are significant differences in health status measures and cardiometabolic health between subgroups of transgender adults and cisgender adults. There is a need for additional research to understand the societal and medical (e.g., hormone therapy) effects on these outcomes.

Considerations on Sampling in Transgender Health Disparities Research

“…8 Overall, probability samples have found no differences in chronic conditions between transgender and cisgender individuals, except that prevalence of myocardial infarction appeared to be elevated among transgender women and gender nonconforming individuals. 6,7,18 In contrast, studies using BRFSS data have consistently reported a higher prevalence of disability and activity limitation in the transgender population than in the cisgender population [5][6][7][8] ; however, the magnitude of this disparity was less than that implied by the findings for transgender people in the USTS. 16 Notably, 41% and 40% of transgender respondents in the NTDS and USTS, respectively, reported at least one lifetime suicide attempt.…”

The Autonomic Regulation of Circulation and Adverse Events in Hypertensive Patients during Follow-Up Study

“…However, it is known that not all hypertensive patients have equal chances for disease progression [2]. e factors of cardiometabolic risk are the most thoroughly investigated: a number of systemic publications are devoted to study of the prognosis of these factors for patients with cardiovascular diseases in developed countries [3]. At the same time, there are often studies in which autonomic regulation and parameters of hemodynamic were studied resulting in inclusion of respective indicators in the management for sudden death issued by the American Heart Association [4].…”

Food Insecurity Among Transgender and Gender Nonconforming Individuals in the Southeast United States: A Qualitative Study

“…Of particular concern were participants' reports of hypertension and high cholesterol, which they attributed to stress and inadequate nutrition arising from food insecurity. Recent population-based studies indicate that gender nonconforming, transgender females, 45 and transgender males 46 exhibited disparities in cardiovascular disease. While larger studies are needed, it may be that food insecurity is an important driver of cardiovascular disease risks.…”