Inmune-mediated inflammatory rheumatic diseases in transgender people: A scoping review

Salgado, Eva; Baurés, Montserrat Romera; Beltrán-Catalán, Emma; Naredo, Esperanza; Carreira, Patrícia; García-Vivar, M.L.; Moreno-Muelas, José Vicente; Boteanu, Alina; Calvo-Penades, Inma; Sellas‐Fernández, Agustí; Valero, Marta; Gόmez-Reino, J.J.

doi:10.1016/j.semarthrit.2021.10.004

Cited by 10 publications

(6 citation statements)

References 49 publications

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“…There is a dearth of information concerning the impact of sexrelated issues on PsA, the epidemiological trends of which among sex-diverse populations have been and are still overlooked in the literature. Little is known about the effects of endocrine hormones on the development of PsA (67) and even less is known about the impact of hormone replacement therapy among transexual individuals (68,69). More studies need to focus on these aspects.…”

Section: Psoriatic Arthritis and Sex-specific Differencesmentioning

confidence: 99%

Sex-Based Medicine Meets Psoriatic Arthritis: Lessons Learned and to Learn

et al. 2022

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Humorally associated autoimmune diseases generally show a female predominance whereas ankylosing spondylitis, a disease that overlaps with psoriatic arthritis (PsA), shows a male predominance. The present review ascertains the current knowledge of sex-specific differences related to psoriatic arthritis (PsA), a chronic, inflammatory condition associated with psoriasis. Sex differences may have important implications for clinical research in PsA and in terms of epidemiology (incidence, prevalence, lifetime risk, survival, and mortality), clinical, radiological, and laboratory features, and response to treatment. While nationwide surveys and large-scale databases and registries show no sex-specific differences, varying male/female ratios have been reported, ranging from 0.42 to 2.75 (comparable with those reported for psoriasis vulgaris: ranging from 0.28 to 2.38). This may reflect subtle, complex, nonlinear interactions between the biological make-up of the individual (genetic and epigenetic differences), hormonal components including menopausal status, environmental exposures including skeletal physical stressing, and psychological variables. There exists methodological heterogeneity and paucity of data concerning sex-specific differences, in terms of the specific population studied, study design, and the diagnostic criteria utilized. Harmonizing and reconciling these discrepancies would be of crucial importance in achieving the ambitious goals of personalized/individualized medicine and further standardized meta-data and Big Data could help disentangle and elucidate the precise mechanisms of underlying potential PsA sex-specific differences.

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Section: Psoriatic Arthritis and Sex-specific Differencesmentioning

confidence: 99%

Sex-Based Medicine Meets Psoriatic Arthritis: Lessons Learned and to Learn

et al. 2022

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“…Regrettably we are not aware of epidemiologic data regarding rheumatic disease in this population nor of prospective data evaluating the effects of GAHT or GAS on rheumatic disease. A recent systematic review of transgender patients with rheumatic disease analyzed 14 such patients, 13 of whom are included in our literature review and study [47 ▪ ]. With the seven additional patients we report our study likely is the largest collection of retrospective data currently available on this patient population.…”

Section: Discussionmentioning

confidence: 99%

Challenges of caring for transgender and gender diverse patients with rheumatic disease: presentation of seven patients and review of the literature

Mathias

Amarnani

et al. 2022

Current Opinion in Rheumatology

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Purpose of reviewAs perspectives on sex and gender identity have evolved, there has been an increase in the practice of transgender medicine. Within rheumatology, however, there is a dearth of information about rheumatic disease in transgender and gender diverse (TGGD) individuals. This is important, as sex hormones affect the etiopathogenesis and expression of autoimmune diseases. We therefore sought to identify TGGD patients with rheumatic disease, review their clinical courses, and appraise existing literature about this population.Recent findingsOf 1053 patients seen at the Los Angeles County and University of Southern California Medical Center from 2019 through 2021, five transgender men and two transgender women with rheumatic disease were identified. Most patients’ disease courses were not overtly impacted by gender affirming hormone therapy (GAHT). Six of seven patients had psychosocial barriers to care. Our systematic review found 11 studies with 11 transgender women and two transgender men. In 12 of 13 patients, GAHT possibly modulated the patients’ rheumatic disease.SummaryOur observations suggest GAHT need not be a strict contraindication in TGGD patients with rheumatic disease. TGGD patients often face significant psychosocial barriers. Additional information about this population and empathy toward their health disparities are needed.

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“…A variety of rheumatic pathologies are known to have a strong immune mediated component, and sexual dimorphism occurs in innate and adaptive immunity and contributes to differences in the prevalence of rheumatic diseases ( 66 ). A recent review commented on the limited literature on arthritis among trans individuals but noted that, though the number of cases was only 14, eleven cases of such immune mediated disorders occur in trans women ( 67 ). In parallel with the functional significance of immune cells on pain mechanisms, there is a greater predisposition to chronic pain among individuals lacking a Y chromosome ( 68 , 69 ).…”

Section: Pain In Relation To Gender Identitymentioning

confidence: 99%

Pain mechanisms in the transgender individual: a review

Anger,

Case,

Baranowski

et al. 2024

Front. Pain Res.

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Specific AimProvide an overview of the literature addressing major areas pertinent to pain in transgender persons and to identify areas of primary relevance for future research.MethodsA team of scholars that have previously published on different areas of related research met periodically though zoom conferencing between April 2021 and February 2023 to discuss relevant literature with the goal of providing an overview on the incidence, phenotype, and mechanisms of pain in transgender patients. Review sections were written after gathering information from systematic literature searches of published or publicly available electronic literature to be compiled for publication as part of a topical series on gender and pain in the Frontiers in Pain Research.ResultsWhile transgender individuals represent a significant and increasingly visible component of the population, many researchers and clinicians are not well informed about the diversity in gender identity, physiology, hormonal status, and gender-affirming medical procedures utilized by transgender and other gender diverse patients. Transgender and cisgender people present with many of the same medical concerns, but research and treatment of these medical needs must reflect an appreciation of how differences in sex, gender, gender-affirming medical procedures, and minoritized status impact pain.ConclusionsWhile significant advances have occurred in our appreciation of pain, the review indicates the need to support more targeted research on treatment and prevention of pain in transgender individuals. This is particularly relevant both for gender-affirming medical interventions and related medical care. Of particular importance is the need for large long-term follow-up studies to ascertain best practices for such procedures. A multi-disciplinary approach with personalized interventions is of particular importance to move forward.

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Inmune-mediated inflammatory rheumatic diseases in transgender people: A scoping review

Cited by 10 publications

References 49 publications

Sex-Based Medicine Meets Psoriatic Arthritis: Lessons Learned and to Learn

Sex-Based Medicine Meets Psoriatic Arthritis: Lessons Learned and to Learn

Challenges of caring for transgender and gender diverse patients with rheumatic disease: presentation of seven patients and review of the literature

Pain mechanisms in the transgender individual: a review

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