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November 20, 2021
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AHA recognizes barriers to CV health among LGBTQ+ people on Transgender Day of Remembrance

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In recognition of Transgender Day of Remembrance, the American Heart Association highlighted risk factors and disparities affecting the CV health of people who are transgender or gender diverse.

As Healio previously reported, data are lacking on how stigmatization-related stress and hormone therapies may impact CV health among transgender and gender-diverse individuals, according to a recent scientific statement published in Circulation.

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Carl Streed Jr.

“Heart disease and stroke do not discriminate,” Carl Streed Jr., MD, MPH, chair of the writing group for the statement, assistant professor of internal medicine at Boston University School of Medicine and the research lead at the Center for Transgender Medicine and Surgery at Boston Medical Center, said in a press release. “This is why we are highlighting the critical science and calling for further action in addressing disparities in health equity for transgender and gender diverse people. There is a need for additional training for clinicians and health care professionals to ensure gender-diverse and transgender people feel safe and welcome in the health care setting. Training is also needed to make sure there is appropriate screening and management of cardiovascular issues and risk factors, particularly those associated with discrimination and stress, that are more prevalent in LGBTQ+ communities, such as smoking and excess alcohol consumption.”

According to the AHA release:

  • Men who are transgender are twice as likely to have a MI compared with men who are cisgender and four times as likely compared with women who are cisgender.
  • People who are transgender and individuals who are gender diverse are also more likely to experience blood clots when undergoing estrogen hormone therapy.
  • Individuals undergoing gender-affirming hormone therapy are more physically active, possibly because they are more satisfied with their bodies.
  • Transgender and gender-diverse youth report more consumption of fast food and use of diet pills, fasting or laxative abuse for weight management.
  • People who are transgender or gender diverse also report overall elevated BMI, which may lead to additive stress since many surgeons have strict BMI cutoffs for performing gender-affirming surgeries.

According to the release, the addition LGBTQ+-related content to health care professional training and licensure requirements could improve health among transgender and gender-diverse individuals. The Accreditation Review Commission on Education for the Physician Assistant already began requiring LGBT curricular content in September 2020.

According to the release, the inclusion of sexual orientation and gender identity information in electronic health records could provide an opportunity to address health concerns among patients who are LGBTQ+ and allow for broader examination in research and public health efforts of their CV health.