Transgender individuals experience some of the greatest health disparities in our communities. While research investigating their health is limited, we do know that they experience challenges in accessing culturally appropriate care and have some of the highest rates of human immunodeficiency virus (HIV) worldwide.
To help physicians understand medical issues unique to transgender patients, the SC CTSI launched an observational study to collect data on markers of cardiovascular and metabolic health and attitudes toward health care from people who are receiving cross-sex hormone therapy. The study is a partnership between the SC CTSI and the LA Gay & Lesbian Center’s director of Transgender Health, Maddie Deutsch, MD.
The pilot study found that barriers to care for transgender individuals include: lack of health insurance, anxiety about seeing a physician, lack of clarity about where to access care, and past negative experiences with a healthcare provider because of transgender identity. The study is the first of its kind to examine the effect of hormone therapy on the general physical health of transgender individuals. The results indicate that cross-sex hormone therapy in a young and generally healthy transgender population appears to have a protective effect on blood pressure in the short term. In addition, the data indicate that there was an increase in the prevalence of obesity seen in female-to-male individuals after the initiation of testosterone therapy.
The results revealed a stigma in the healthcare system associated with a patient’s transgender identity. Moreover, the partnership between medical providers and transgender advocates/ organizations are important to ensure access to care for this highly vulnerable population. The preliminary information on cardiovascular and metabolic health points to both risk and protective factors as a result of cross-sex hormone therapy. Multi-site, national trials are in discussion to further explore these issues.