At the annual meeting of the European Association for the Study of Diabetes held in September in Lisbon, Portugal, Dr. Patricia Kapsner and colleagues from the University of New Mexico, Albuquerque, highlighted their findings regarding modifiable risk factors associated with the development of diabetes in transgender individuals.

The research team focused on a population of 300 transgender patients attending the team’s multidisciplinary clinic. Because transgender individuals identify with a gender that is different from the sex assigned at their birth, gender-affirming hormone treatment is often necessary to acquire the sex characteristics that better align with the person’s identity. The adverse effects of these hormones have not been adequately studied in the transgender population; however, it is known that hormonal supplementation may contribute to adverse cardiovascular consequences such as abnormal lipids, altered blood glucose, and increased weight.

The researchers found that diabetic transgender patients who were taking hormones for gender affirmation were more often obese and had higher triglycerides, higher LDL, and lower HDL than their counterparts not taking confirmation hormones. These differences were especially notable in transgender women (assigned male sex at birth) using estrogen. Additional findings included psychosocial issues such as substance abuse and psychological dysphoria, which contibuted to further challenges in managing both diabetes and comorbid conditions.

Recent estimates from state and federal data suggest that around 0.6% of the adult population in the United States (1.4 million adults) identifies as transgender. The troubling confounder for this transgender population is that nearly half (40%) of the adult U.S. population is expected to develop type 2 diabetes at some point during their lifetime. The importance of reducing additional risk factors, therefore, becomes an even more compelling public-health issue.  
According to the research team for both transgender men and women, it is critical to reduce risk factors for diabetes to prevent cardiovascular disease and other complications. They also noted that their goal is to help boost transgender health and diabetes services to provide effective support and medication to those most in need.

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