Transgender Mortality Rate and Social Determinants of Health
The LGBTQ+ community has a long history of being discriminated against, and even though it has gained tremendous social support, this discrimination is still prevalent today. Cisgender people identify with their birth sex whereas transgender people do not identify with the sex they were assigned at birth. Many transgender people face medical discrimination, which can be harmful because gender affirming care significantly reduces the risk of depression, anxiety, and gender dysphoria, especially in transgender youth. Understanding how the acceptance of transgender people affects their medical care is imperative to decreasing discrimination and increasing their quality of life because they face an increased suicide risk that is much higher than the suicide risk of the general population.
Past studies have shown that the transgender population has a higher mortality rate than the cisgender population or how long-term use of hormone therapy affects the health and mortality outcomes of transgender patients. To investigate this further, researchers in the Netherlands conducted a study to determine how many transgender women and men using hormone therapy died over the course of fifty years, how they died, whether their death could be linked to the treatment, and if the mortality rate has increased or decreased.
This study focused on 4658 transgender people over the course of fifty years. The researchers found that the group had a mortality rate of 628 deaths per 100,000 person-years, which means that the mortality rate has not lowered after five decades. Also, the overall mortality risk is higher for both transmen and transwomen compared to cismen and ciswomen. The most common causes of death for transwomen were HIV-related disease and suicide, the majority coming from the first few decades of the study, followed by cardiovascular disease, and lung cancer. The increased mortality rate of transmen in the last ten years was also not correlated with hormone therapy. The most common causes of death for transmen were non-natural causes of death, such as suicide.
Past studies have shown that the transgender population has a higher mortality rate than the cisgender population or how long-term use of hormone therapy affects the health and mortality outcomes of transgender patients. To investigate this further, researchers in the Netherlands conducted a study to determine how many transgender women and men using hormone therapy died over the course of fifty years, how they died, whether their death could be linked to the treatment, and if the mortality rate has increased or decreased.
This study focused on 4658 transgender people over the course of fifty years. The researchers found that the group had a mortality rate of 628 deaths per 100,000 person-years, which means that the mortality rate has not lowered after five decades. Also, the overall mortality risk is higher for both transmen and transwomen compared to cismen and ciswomen. The most common causes of death for transwomen were HIV-related disease and suicide, the majority coming from the first few decades of the study, followed by cardiovascular disease, and lung cancer. The increased mortality rate of transmen in the last ten years was also not correlated with hormone therapy. The most common causes of death for transmen were non-natural causes of death, such as suicide.
Hormone therapy, or gender affirming therapy, is used to help transgender patients transition to the gender they identify with. They can be given a feminizing hormone therapy (estrogen) or masculinizing hormone therapy (testosterone), which can be administered through injections, oral medications, or even placed onto the skin as a cream, gel, or patch. These treatments, which can be started during puberty for transgender youth, are effective ways to improve the quality of life, gender dysphoria, and emotional as well as social distress of transgender individuals.
Image Source: RF._.studio
The increased acceptance of transgender people has improved their access to medical care and spread awareness in the medical community about suicide risk in transgender patients as well as their unique mental and physical challenges. However, higher transgender mortality rates are not only due to medical factors, but also due to how stigma reduces access to care and affects their physiological functioning and disease susceptibility. For instance, transphobia, homophobia, sexual and gender roles, and being unable to talk about their feelings and experiences are all considered to be social determinants of health for the LGBTQ+ community, especially for youth. All of these factors impact the health of the transgender population and ultimately their mortality rate.
This study has a few limitations. Since this study looked at patients after they died, there was not much information about their treatment regimen, comorbidities, lifestyle, or potential risk factors. Also, the study’s findings may not be generalizable because the experience of a transgender person in the United States is distinct from the experiences of a transgender person, for instance, in the Netherlands (differing access to healthcare and traits (e.g. body mass index).
Despite these limitations, the findings of this study are important for the health of the transgender population because their health outcomes should be contextualized within the broader context of social inequalities. Tackling the health inequities and disparities transgender people face by recognizing the impact discrimination and social inequities have on both their mental and physical health can help us advocate for the well-being of transgender individuals.
This study has a few limitations. Since this study looked at patients after they died, there was not much information about their treatment regimen, comorbidities, lifestyle, or potential risk factors. Also, the study’s findings may not be generalizable because the experience of a transgender person in the United States is distinct from the experiences of a transgender person, for instance, in the Netherlands (differing access to healthcare and traits (e.g. body mass index).
Despite these limitations, the findings of this study are important for the health of the transgender population because their health outcomes should be contextualized within the broader context of social inequalities. Tackling the health inequities and disparities transgender people face by recognizing the impact discrimination and social inequities have on both their mental and physical health can help us advocate for the well-being of transgender individuals.
Featured Image Source: Sharon McCutcheon
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