Mortality trends over five decades in adult transgender people receiving hormone treatment: a report from the Amsterdam cohort of gender dysphoria

Blok, Christel J.M. de; Wiepjes, Chantal M.; Velzen, Daan van; Staphorsius, Annemieke S.; Nota, Nienke M.; Gooren, Louis; Kreukels, Baudewijntje P.C.; Heijer, Martin den

doi:10.1016/s2213-8587(21)00185-6

Cited by 66 publications

(80 citation statements)

References 25 publications

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“…Based on the studies above, it may be hypothesized that trans women have a higher risk of type 2 diabetes compared with men in the general population, and that the risk is lower in trans men compared with women in the general population. This would be in line with the currently unexplained increased incidence of cardiovascular disease ( 11 ) and cardiovascular related mortality in trans women ( 12 ). Given the association of insulin resistance with type 2 diabetes, early recognition and prevention is paramount.…”

supporting

confidence: 62%

Incident Diabetes Risk Is Not Increased in Transgender Individuals Using Hormone Therapy

Velzen

Wiepjes

Nota

et al. 2021

The Journal of Clinical Endocrinology &Amp; Metabolism

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Background In trans women receiving hormone therapy, body fat and insulin resistance increases, with opposite effects in trans men. These metabolic alterations may alter the risk of developing type 2 diabetes in trans women and trans men. We aimed to compare the incidence of type 2 diabetes of adult trans women and trans men during hormone therapy with rates from their birth sex in the general population. Methods Retrospective data from the Amsterdam Cohort of Gender Dysphoria with transgender individuals on hormone therapy between 1972 and 2018 were linked to a nationwide health data registry. Because no central registry of diabetes is available, the occurrence of diabetes was inferred from the first dispense of a glucose-lowering agent. Standardized incidence ratios (SIR) were computed for trans women and trans men in comparison with the same birth sex from the general population. Results Compared to their birth sex in the general population, no difference in the incidence of type 2 diabetes mellitus was observed in trans women (N=2585, 90 cases, SIR 0.94 95%CI 0.76–1.14) or trans men (N=1514, 32 cases, SIR 1.40 95%CI 0.96–1.92). Conclusion Despite studies reporting an increase in insulin resistance in feminizing hormone therapy and a decrease in insulin resistance in masculinizing hormone therapy, the incidence of diabetes in transgender individuals after initiation of hormone therapy was not different compared to the general population.

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supporting

confidence: 62%

Incident Diabetes Risk Is Not Increased in Transgender Individuals Using Hormone Therapy

Velzen

Wiepjes

Nota

et al. 2021

The Journal of Clinical Endocrinology &Amp; Metabolism

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“…Transgender (trans) people experience adverse health outcomes and increased mortality [ 1 , 2 ]. Poor healthcare has been identified as one of many factors that lower quality of life for trans people [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Care of Transgender Patients: A General Practice Quality Improvement Approach

Boyd¹,

Hackett

Bewley

2022

Healthcare

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Primary care must ensure high quality lifelong care is offered to trans and gender minority patients who are known to have poor health and adverse healthcare experiences. This quality improvement project aimed to interrogate and audit the data of trans and gender minority patients in one primary care population in England. A new data collection instrument was created examining pathways of care, assessments and interventions undertaken, monitoring, and complications. General practitioners identified a sample from the patient population and then performed an audit to examine against an established standard of care. No appropriate primary care audit standard was found. There was inconsistency between multiple UK gender identity clinics’ (GIC) individual recommended schedules of care and between specialty guidelines. Using an international, secondary care, evidence-informed guideline, it appeared that up to two-thirds of patients did not receive all recommended monitoring standards, largely due to inconsistencies between GIC and international guidance. It is imperative that an evidence-based primary care guideline is devised alongside measurable standards. Given the findings of long waits, high rates of medical complexity, and some undesired treatment outcomes (including a fifth of patients stopping hormones of whom more than half cited regret or detransition experiences), this small but population-based quality improvement approach should be replicated and expanded upon at scale.

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“…GAHT has been regarded as safe when following guidelines to ensure that sex hormone concentrations do not exceed values found in men and women ( 1 ). However, recent large cohort studies have raised concerns about the long-term risk of cardiovascular disease after receipt of GAHT ( 2 , 3 ). Transgender women followed at the Amsterdam Cohort of Gender Dysphoria experienced higher than expected cardiovascular deaths compared to the general Dutch population ( 2 ).…”

mentioning

confidence: 99%

Gender-affirming Hormone Therapy and Risk of Diabetes in Transgender Persons

Tangpricha

2022

The Journal of Clinical Endocrinology &Amp; Metabolism

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Mortality trends over five decades in adult transgender people receiving hormone treatment: a report from the Amsterdam cohort of gender dysphoria

Cited by 66 publications

References 25 publications

Incident Diabetes Risk Is Not Increased in Transgender Individuals Using Hormone Therapy

Incident Diabetes Risk Is Not Increased in Transgender Individuals Using Hormone Therapy

Care of Transgender Patients: A General Practice Quality Improvement Approach

Gender-affirming Hormone Therapy and Risk of Diabetes in Transgender Persons

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