Abstract
Introduction: Existing data on cardiovascular disease among transgender people are inconsistent and are derived from nonrepresentative samples or population-based data sets that do not include transgender-specific risk factors such as gender-affirming hormone use and gender minority stressors. A nationally representative sample of cisgender and transgender adults aged ≥40 years was used to assess the prevalence and correlates of smoking, select cardiovascular disease conditions, and venous thromboembolism. Methods: Participants were recruited from 2016 to 2018, with analysis conducted in December 2020 with 114 transgender and 964 cisgender individuals. Sample weights and multiple imputations were used for all estimates except for descriptive statistics. Logistic regression models estimated the ORs and 95% CIs expressing the relationship between each outcome variable and a set of independent variables. Each model controlled for race and age. Results: No meaningful differences between cisgender and transgender participants were found in smoking or cardiovascular disease conditions. However, there was an increased odds of venous thromboembolism among transgender women compared with those among cisgender women. Transgender people had greater odds of discrimination, psychological distress, and adverse childhood experiences. These stressors were associated with increased odds of a cardiovascular condition, and everyday discrimination and adverse childhood experiences were associated with increased odds of smoking. Discrimination and psychological distress were associated with venous thromboembolism. Conclusions: Transgender people face disparities in cardiovascular disease risk. This study provides support for the gender minority stress model as a framework for understanding cardiovascular disease disparities. Future research with larger samples and adjudicated outcomes is needed to advance the field.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 804-811 |
| Number of pages | 8 |
| Journal | American journal of preventive medicine |
| Volume | 61 |
| Issue number | 6 |
| Early online date | Aug 4 2021 |
| DOIs | |
| State | Published - Dec 2021 |
Bibliographical note
Funding Information:The content of this paper is solely the responsibility of the authors and does not necessarily represent the official views of NIH. TransPop was funded by a grant from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (Grant R01HD090468) and through a supplement to grant R01HD078526 from NIH, Office of Behavioral and Social Sciences Research, and the Office of Research on Women's Health. The TransPop investigators are as follows: Ilan H. Meyer (principal investigator), Walter O. Bockting, Jody L. Herman, and Sari L. Reisner (coinvestigators, listed alphabetically). TP conceived and designed the analysis; SD, WB, and IHM contributed data or analysis tools; SD performed the analysis; and TP and CS wrote the first draft of the paper. All coauthors edited the paper and approved the final submitted version. CS received support from the American Heart Association (20CDA35320148) for his work on this manuscript, and TP was supported by the National Institute on Aging (P30 AG066615). TP has received research support from Gilead Sciences and ViiV Healthcare. No financial disclosures were reported by the authors of this paper.
Funding Information:
TransPop was funded by a grant from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (Grant R01HD090468 ) and through a supplement to grant R01HD078526 from NIH , Office of Behavioral and Social Sciences Research , and the Office of Research on Women's Health . The TransPop investigators are as follows: Ilan H. Meyer (principal investigator), Walter O. Bockting, Jody L. Herman, and Sari L. Reisner (coinvestigators, listed alphabetically).
Funding Information:
CS received support from the American Heart Association ( 20CDA35320148 ) for his work on this manuscript, and TP was supported by the National Institute on Aging ( P30 AG066615 ). TP has received research support from Gilead Sciences and ViiV Healthcare.
Publisher Copyright:
© 2021 American Journal of Preventive Medicine
