Does being transgender cause additional health risks?
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Health Risks Associated with Being Transgender
Cancer Risks in Transgender Individuals
Transgender individuals face unique health risks, particularly concerning cancer. The administration of cross-sex hormones for gender affirmation, often at high doses over long periods, raises concerns about their potential carcinogenic effects. Additionally, transgender people may have increased exposure to risk factors such as sexually transmitted infections, smoking, and alcohol use, compounded by inadequate access to cancer screening. These factors collectively highlight the need for more extensive research to understand and mitigate cancer risks in this population.
Cardiovascular Health in Transgender People
Cardiovascular disease is another significant health concern for transgender individuals. Gender-affirming hormone therapy (GHT) can influence cardiovascular health, with studies showing mixed results. For instance, transgender men on testosterone therapy may experience increased systolic blood pressure, while transgender women on estrogen therapy may see a decrease in systolic blood pressure. However, the overall cardiovascular risk remains high due to factors like increased substance use, mental health disorders, and chronic stress. Routine monitoring and tailored cardiovascular care are essential for this population.
Mental Health and Psychosocial Stressors
Transgender individuals often experience higher rates of mental health issues, including depression, anxiety, and psychosis. The stress associated with minority status, stigma, and discrimination significantly contributes to these mental health challenges . Studies have shown that transgender people are at a higher risk of non-affective psychotic disorders, particularly those who have not yet accessed gender-affirmative care. Addressing these mental health disparities requires comprehensive support systems and interventions to reduce stigma and improve access to mental health services.
General Health and Access to Care
Transgender individuals generally report poorer health outcomes compared to cisgender individuals. They have higher rates of poor general health, myocardial infarction, and lack of healthcare coverage. Additionally, transgender people often face barriers to accessing healthcare, including discrimination and a lack of knowledgeable providers. These barriers contribute to unmet health needs and highlight the importance of improving healthcare access and quality for transgender populations.
Venous Thromboembolism Risk
Estrogen therapy in transgender women has been associated with an increased risk of venous thromboembolism (VTE). A systematic review estimated the incidence rate of VTE to be 2.3 per 1000 person-years among transgender women on estrogen therapy, although significant heterogeneity in the data suggests the need for more research to confirm these findings and optimize therapy regimens.
Health of Transgender Older Adults
Transgender older adults face compounded health risks, including poor physical health, disability, and higher levels of depressive symptoms and perceived stress. Factors such as fear of accessing health services, internalized stigma, and lack of social support contribute to these adverse health outcomes. Addressing these issues requires targeted interventions to reduce stigma and improve social support for transgender older adults.
Conclusion
Transgender individuals face a range of additional health risks, including increased cancer and cardiovascular disease risks, mental health challenges, and barriers to healthcare access. Addressing these risks requires comprehensive, culturally competent healthcare that includes routine monitoring, mental health support, and efforts to reduce stigma and discrimination. Further research is essential to fully understand and mitigate these health risks, ensuring better health outcomes for transgender populations.
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