Gender Matters

With November 20 being the Transgender Day of Remembrance, the American Heart Association (AHA) is drawing attention to unique factors affecting transgender health and related healthcare disparities and poor access to care for transgender people. AHA finds that there are higher levels of heart disease among transgender and gender diverse people that are linked to stresses of experiencing discrimination and poorer health outcomes linked to lack of equitable access for care, as well as transgenders’ higher levels of smoking and obesity. BU Prof. Carl Streed MD., MPH, leads research at the Center for Transgender Medicine and Surgery at Boston Medical Center. Dr. Streed asserts more training is needed for clinicians and healthcare professionals to ensure gender diverse and transgender people feel safe and welcome in healthcare settings, as well as careful screening and management of cardiovascular issues and risk factors. Also, the Accreditation Review Commission for accrediting Physician Assistants now must undertake LGBT curricular content, including learning how to protect sexual orientation and gender identity information in electronic health records and information that allows broader examination in research and public health efforts of the cardiovascular health of LGBT adults. Interestingly, the AHA is expanding its heart-related research to also study brain health and also, tracks how heart disease uniquely affects the LBGTQ+ population. Transgender and gender diverse populations also face unique psychological stressors, including gender non-affirmation, discrimination, concealment of gender identity and violence based on gender identity. These factors contribute to higher levels of stress, which can negatively affect heart health. Also, transgender and gender diverse people who are also part of historically excluded racial or ethnic groups experience multiple layers of stress, such as lower income levels or limited access to to healthcare. References American Heart Association. “Health disparities and equitable access to health care persist with transgender adults” online 17 Nov 2021. American Heart Association. “Gender-affirming hormone therapy may increase risk of high blood pressure” Accreditation Review Commission. Education for the Physician Assistant (ARC-PA), available at http://www.arc-pa.org/wp-content/uploads/2019/04/ARC-PA-Logo-color.jpg.