Billy A. Caceres
PHILADELPHIA — Transgender and gender-nonconforming adults who experience discrimination are more likely to report increased CV risk factors, such as excessive drinking and short sleep, but social support from family members may weaken the association.
Despite potentially elevated risk for CVD related to social stress and exogenous hormone use, few studies have examined CV risk among transgender individuals, Billy A. Caceres, PhD, RN, AGPCNP-BC, an assistant professor at Columbia University School of Nursing, and colleagues wrote in an abstract presented at the American Heart Association Scientific Sessions.
“Our findings indicate that there is a need for clinicians to recognize the role of stressors in explaining the potential CV health disparities in transgender and gender-nonconforming persons,” Caceres told Healio. “It also highlights the important role of social support, especially from one’s family, as a resource in promoting the health of this population.”
Caceres and colleagues conducted a cross-sectional study using data from 288 individuals participating in Project AFFIRM, a study that aims to learn more about the identity development and health of people who identify as transgender, gender nonconforming or nonbinary (50.7% were assigned female at birth; mean age, 34 years). Researchers used linear and logistic regression models to separately examine the associations between minority stressors, social support and hormone use with self-reported CV risk factors, such as tobacco and alcohol use, inadequate sleep duration (defined as < 7 hours), physical inactivity and BMI, adjusted for demographic characteristics. The researchers then examined whether social support moderated the association between minority stressors and CV risk factors.
Experiences of discrimination were associated with higher rates of risky drinking (adjusted OR = 1.2; 95% CI, 1.1-1.3) and lower rates of adequate sleep duration (aOR = 0.8; 95% CI, 0.7-0.9). Internalized transphobia was associated with lower rates of physical activity (aOR = 0.8; 95% CI, 0.6-0.9). The researchers did not report an association between minority stressors and tobacco use or BMI, according to the results.
Transgender and gender-nonconforming adults who experience discrimination are more likely to report increased CV risk factors, such as excessive drinking and short sleep, but social support from family members may weaken the association.
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In addition, social support was linked with higher odds of adequate sleep duration (aOR = 1.5; 95% CI, 1.2-1.9) and adequate physical activity levels (aOR = 1.3; 95% CI, 1.1-1.7). Social support also moderated the association between discrimination and adequate sleep duration (aOR = 0.9; 95% CI, 0.8-0.9), indicating that social support is a “resilience factor,” according to the researchers.
“We found that social support, in particular from family members, weakened the association between discrimination and sleep, suggesting that familial social support might be a protective health factor,” Caceres said.
In other results, gender-affirming hormone therapy use was not associated with elevated CV risk.
“Health initiatives that focus on increasing effective coping strategies in the face of minority stressors and enhance social support might be beneficial for the CV health of transgender and gender-nonconforming persons,” Caceres said. “As more Americans identify as transgender and gender nonconforming at younger ages, it is important for interdisciplinary health teams to understand the potential benefits of family-based interventions that focus on promoting the health of this population. Clinicians should advocate for policies that protect against discrimination of transgender and gender-nonconforming persons, as these might have important implications for their health and well-being.” – by Regina Schaffer
Caceres BA, et al. Presentation 123. Presented at: American Heart Association Scientific Sessions; Nov. 16-18, 2019; Philadelphia.
Disclosure: Caceres reports no relevant financial disclosures.