Priorities for transgender medical and healthcare research

Abstract

Purpose of Review Transgender individuals experience unique health disparities but are the subject of little focused health research. This manuscript reviews current literature on transgender medical and mental health outcomes and proposes research priorities to address knowledge gaps. Recent Findings Published research in transgender health care consists primarily of case reports, retrospective and cross-sectional studies, involving largely European settings. Challenges to US-based transgender health research include a diverse population where no single center has sufficient patient base to conduct clinical research with statistical rigor. Treatment regimens are heterogeneous and warrant study for best practices. Current research suggests increased mortality and depression in transgender individuals not receiving optimal care, and possibly a modest increase in cardiovascular risk related to hormone therapy. Current evidence does not support concerns for hormone related malignancy risk. Summary The priorities for transgender medical outcomes research should be to determine health disparities and co-morbid health conditions over the life span, along with the effects of mental health, medical, and surgical interventions on morbidity and mortality. Specific outcomes of interest based on frequency in the literature, potential severity of outcome, and patient-centered interest, include affective disorders, cardiovascular disease, malignancies, fertility, and time-dose related responses of specific interventions.

Moral Challenges in Transgender Care: A Thematic Analysis Based on a Focused Ethnography

“…Elucidating the latter will foster a more explicit moral deliberation in which the potential therapeutic benefits of single treatment steps can be weighed against potential pitfalls. Finally, our findings underscore the call for sound qualitative and quantitative research to inform guidelines and best practices, along with follow-up research on experiences with the provided care (Deutsch et al, 2016; Feldman et al, 2016). …”

Prevalence of pregnancy involvement among Canadian transgender youth and its relation to mental health, sexual health, and gender identity

“…Clearly, more research is needed into the past or current hormone usage in transgender people who report pregnancy involvement using clinical samples of youth and young adults, rather than community samples that cover a wide array of topics in brief (Feldman et al, 2016). Given the small number of participants who reported that they were currently pregnant, our findings suggest that most of the transgender youth in our sample who reported a history of pregnancy 1 We thank an anonymous reviewer for suggesting to assess circumstance.…”

Transgender Medicare Beneficiaries and Chronic Conditions: Exploring Fee-for-Service Claims Data

“…The literature on the burden of these types of nonmental health chronic conditions in transgender individuals is very sparse, especially in the United States, and even more so for older transgender adults. 40 Two small studies have shown similar findings for cardiovascular disease and diabetes; however, the studies were both conducted only with transgender patients on hormone therapy, and effects varied by sex assigned at birth. 41,42 A narrative review provides additional examination of transgender people taking hormones and the risk factors for cardiovascular disease.…”