TOPLINE Transgender people are twice as likely to die as cisgender people, according to a long running study published in the Lancet Diabetes & Endocrinology on Thursday, a difference researchers said underscores the need for improving social acceptance and medical care for trans people.
The increased risk did not fall over the almost five decades studied between 1972 and 2018, according to an analysis of medical records from nearly 3,000 trans women and more than 1,600 trans men treated at the Amsterdam University Medical Center, which treats around 90% of trans people in the country.
Trans women had particularly elevated risks of death—notably from heart disease, lung cancer, HIV-related illness and suicide—the researchers noted, and were almost twice as likely to die than cis men and nearly three times as likely to die than cis women.
There were no differences in the risks of death between trans and cisgender men, the study found, though the group was almost twice as likely to die than cis women, especially from non-natural causes like suicide.
The researchers said the findings add weight to the idea that the health disparities observed in transgender people are not primarily driven by gender-affirming hormone treatment—which can potentially increase the likelihood of some conditions—as most causes of increased death identified have no indication of being a consequence of this.
Lead author Martin den Heijer said bolstering social acceptance and improving healthcare for trans people, particularly for heart disease, tobacco use, and HIV, will be important for decreasing the risk of death, adding that further research will be needed to “fully establish” any long-term risk to hormone treatment.
It is well documented that transgender and gender non-conforming people, particularly trans women, have much higher risks of death and illness than the general population. Hormone therapy has been identified as a possible, though not definite, contributor towards this. Trans adults are at a much greater risk of dealing with suicidal thoughts and attempting suicide than cisgender adults, as well as more likely to experience homelessness, violence and discrimination.
WHAT DON’T KNOW
As the study is observational and based on medical records, it is possible other factors not recorded could have contributed towards the higher death rates in transgender people. The authors stress caution when applying its findings to other regions, which may use different kinds of gender-affirming hormone treatment and the 90% white study group. In a linked comment, Emory University’s Dr. Vin Tangpricha, who was not involved in the study, said gender-affirming hormone treatment for trans women in the U.S. and U.K. typically differs and could raise different safety concerns.
First author Christel de Blok said most suicides and deaths related to HIV in the study occurred in the first decades studied, “suggesting that greater social acceptance and access to support, and improved treatments for HIV, may have played an important role in reducing deaths related to these causes among transgender people in recent years.”
If you or someone you know is thinking about suicide, please call the National Suicide Prevention Lifeline at 0800 567 567 or visit sadag.org
By Robert Hart, Forbes Staff