Top Things to Know: Assessing and Addressing CV Health in People Who Are Transgender and Gender Diverse (TGD)
Published: July 08, 2021
Prepared by Paul St. Laurent, DNP, RN, Sr. Science and Medicine Advisor, Lead
- Research increasingly indicates that people who are transgender and gender diverse (TGD) experience disparities in a variety of cardiovascular (CV) risk factors and outcomes compared to their non-TGD peers.
- The objectives of this statement are to: 1) present a conceptual model to present pathways and mechanisms underlying CV health disparities in people who are TGD, 2) identify research gaps, and 3) provide suggestions for systematically improving cardiovascular research and care of TGD people.
- Cardiovascular health disparities in people who are TGD are posited to be driven by manifestations of stigma as a fundamental social determinant of health (e.g., violence, discrimination, poverty).
- The statement reviews literature on TGD disparities as it relates to the components of the American Heart Association’s Life’s Simple 7, including tobacco use, physical activity, diet, weight status, blood pressure, glycemic status, and lipids.
- The statement reviews findings about how hormone therapy may modify CV health for each component of the AHA Life’s Simple 7.
- There is limited understanding of the cardiovascular health of TGD people with multiple stigmatized identities (e.g., racial and ethnic minorities, low-income).
- Longitudinal research examining psychosocial, behavioral, and clinical determinants of optimal cardiovascular health in TGD people at the individual, interpersonal, and structural levels is needed to identify targets for interventions over the life course.
- Clinicians and other health professionals need training on identifying TGD health disparities and the proper assessment of sex and gender in healthcare settings.
- The inclusion of sex and gender identity measures in electronic health records as well as public health surveillance systems provides an opportunity to leverage these data to examine cardiovascular health among people who are TGD.
- Content targeted specifically to TGD health should be incorporated in health professions curricula and TGD-related accreditation and licensure requirements are needed for health professionals.
Citation
Streed CG Jr, Beach LB, Caceres BA, Dowshen NL, Moreau KL, Mukherjee M, Poteat T, Radix A, Reisner SL, Singh V; on behalf of the American Heart Association Council on Peripheral Vascular Disease; Council on Arteriosclerosis, Thrombosis and Vascular Biology; Council on Cardiovascular and Stroke Nursing; Council on Cardiovascular Radiology and Intervention; Council on Hypertension; and Stroke Council. Assessing and addressing cardiovascular health in people who are transgender and gender diverse: a scientific statement from the American Heart Association [published online ahead of print July 8, 2021]. Circulation. doi: 10.1161/CIR.0000000000001003