271247 Hormones = Health. Health outcomes among transgender clients in an urban health center

Monday, October 29, 2012 : 1:45 PM - 2:00 PM

Anita Radix, MD MPH , Mailman School of Public Health (Epidemiology), Columbia University, New York, NY
Transgender and gender nonconforming (TGNC) individuals exist in all societies, however their medical and psychosocial needs are largely unmet. Although male-to-female transgender women (MTFs) in the USA are disproportionately affected by HIV, mainly due to stigma, social isolation and economic marginalization, little is known about the risks of HIV infection among female-to-male and other trans-masculine spectrum individuals. Information on most health outcomes, including those related to cross-gender hormone therapy (CGHT), is limited, especially for TGNC persons of color.

Callen-Lorde Community Health Center in NYC predominantly serves racially and economically diverse LGBT communities and people living with HIV. Currently about 2200 TGNC persons access services. 196 MTF and 2 FTM clients are HIV-infected.

The Transgender Data Project is a 2-year retrospective chart review of transgender patients, >18 y/o, to investigate utilization of health services and health outcomes among TGNC persons, especially those receiving CGHT.

Preliminary results on health outcomes of HIV-infected MTF are available. During the study period 1139 MTFs were in care of whom 196 were HIV+ (17.2%). HIV+ MTFs (39.2% with an AIDS diagnosis) were predominantly non-white (86%) with high rates of unemployment (58%), substance use (18.4%), less than high school education (17.8%) and anxiety/depression (70%). Most (76.2%) were receiving CGHT. Comorbidities included Hepatitis C infection (11.6%) and diabetes mellitus (6.3%). 48.7% were overweight (BMI>25%). Silicone use was 10% and highest among Latinas (aOR 6.07, 95%CI: 1.8-20.4). No serious adverse outcomes were associated with CGHT. Despite having multiple pyschosocial factors that predict low adherence to antiretroviral therapy, most clients demonstrated high rates of medication compliance and successful immunological response to treatment.

In addition to higher prevalence of HIV, the TGDP has identified other health disparities disproportionately affecting TGNC people of color, including uptake of preventive screenings, rates of obesity and substance use.

Learning Areas:
Advocacy for health and health education
Diversity and culture

Learning Objectives:
Describe the health issues affecting transgender and gender non-conforming individuals Compare the differences in health priorities affecting transgender/gender nonconforming people of color

Keywords: Gender, Health Disparities

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Cross-Gender Hormone Therapy

Qualified on the content I am responsible for because: I am a physician and HIV specialist working in transgender health and Director of Research and Education at Callen_Lorde Community Health Center. I am the principal investigator of the Transgender Data Project, a 2 year project to investigate health outcomes among transgender and gender nonconforming individuals.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.