- Transgender men and women had higher risk for myocardial infarction (MI) than cisgender counterparts in this cross-sectional study of national survey data.
- Transgender women vs cisgender men was the only exception among the comparisons.
- Editorial discusses transgender invisibility, health disparities, many remaining unknowns; calls for long-term cohort studies.
Why this matters
- Most cardiovascular research assumes gender binary.
- Numbering 1.4 million, the US transgender population faces social stressors, health problems, substance abuse, low socioeconomic status.
- Recent meta-analysis finding low MI rates among transgender people using hormones addressed relatively young population.
- Mean ages: transgender men, 51.4 years; transgender women, 53.1 years.
- MI ORs (95% CIs) in logistic regression models:
- Transgender women vs cisgender women: 2.56 (1.78-3.68; P<.01>
- Transgender women vs cisgender men: no significant difference.
- Transgender men vs cisgender men: 2.53 (1.14-5.63; P=.02).
- Transgender men vs cisgender women: 4.90 (2.21-10.90; P<.01>
- Cross-sectional study of Behavioral Risk Factor Surveillance System, 2014-2017, which does not assume gender binary (n=1,842,439).
- Outcome: associations between gender identity and MI odds.
- Models adjusted for age, diabetes, chronic kidney disease, smoking, hypertension, hypercholesterolemia, exercise.
- Funding: None disclosed.
- Causation not established.
- No data on hormone therapy, psychosocial factors, timing of MI.
- Potential recall bias.