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Curr Opin Endocrinol Diabetes Obes. 2016 Apr;23(2):180-7. doi: 10.1097/MED.0000000000000231.

Priorities for transgender medical and healthcare research.

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aDepartment of Family Medicine and Community Health, University of Minnesota, Minneapolis, Minnesota bDepartment of Psychiatry and Behavioral Sciences, Quillen College of Medicine, East Tennessee State University, Mountain Home VAMC, Johnson City, Tennessee cDepartment of Family and Community Medicine, University of California, San Francisco, California dProgram of Developmental Psychoendocrinology, Division of Gender, Sexuality, and Health, College of Physicians and Surgeons, Columbia University Medical Center and NYS Psychiatric Institute, New York City, New York eDepartment of Psychiatry, University of Texas, Medical Branch, Galveston, Texas fDepartment of Psychiatry, College of Physicians and Surgeons, Columbia University Medical Center, New York City, New York gDivision of Endocrinology, Metabolism and Lipids, Department of Medicine, Emory University School of Medicine and the Atlanta VA Medical Center, Atlanta, Georgia, USA hDepartment of Endocrinology, Center for Sexology and Gender, Ghent University Hospital, Ghent, Belgium iSection of Endocrinology, Diabetes, and Nutrition, Boston University School of Medicine, Boston, Massachusetts, USA.



Transgender individuals experience unique health disparities but are the subject of little focused health research. This manuscript reviews current literature on transgender medical and mental health outcomes and proposes research priorities to address knowledge gaps.


Published research in transgender healthcare consists primarily of case reports, retrospective and cross-sectional studies, involving largely European settings. Challenges to US-based transgender health research include a diverse population where no single center has sufficient patient base to conduct clinical research with statistical rigor. Treatment regimens are heterogeneous and warrant study for best practices. Current research suggests increased mortality and depression in transgender individuals not receiving optimal care, and possibly a modest increase in cardiovascular risk related to hormone therapy. Current evidence does not support concerns for hormone-related malignancy risk.


The priorities for transgender medical outcomes research should be to determine health disparities and comorbid health conditions over the life span, along with the effects of mental health, medical, and surgical interventions on morbidity and mortality. Specific outcomes of interest based on frequency in the literature, potential severity of outcome, and patient-centered interest, include affective disorders, cardiovascular disease, malignancies, fertility, and time dose-related responses of specific interventions.

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