Tuesday, January 02, 2018

The Doctor Is In

There are very little research in our healthcare and our overall health. Do we have more non-trans medical problems than the general population?

There is a study posted on the National Institutes of Health's National Library of Medicine (NIH/NLM) website on our health.
Transgender Medicare Beneficiaries and Chronic Conditions: Exploring Fee-for-Service Claims Data
Christina N. Dragon, MSPH, corresponding author Paul Guerino, ScM, Erin Ewald, ScM, and Alison M. Laffan, PhD
LGBT Health. 2017 Dec 1; 4(6): 404–411.
Published online 2017 Dec 1. doi:  10.1089/lgbt.2016.0208

Purpose: Data on the health and well-being of the transgender population are limited. However, using claims data we can identify transgender Medicare beneficiaries (TMBs) with high confidence. We seek to describe the TMB population and provide comparisons of chronic disease burden between TMBs and cisgender Medicare beneficiaries (CMBs), thus laying a foundation for national level TMB health disparity research.
Results: Compared to CMBs, a greater observed proportion of TMBs are young (under age 65) and Black, although these differences vary by entitlement. Regardless of entitlement, TMBs have more chronic conditions than CMBs, and more TMBs have been diagnosed with asthma, autism spectrum disorder, chronic obstructive pulmonary disease, depression, hepatitis, HIV, schizophrenia, and substance use disorders. TMBs also have higher observed rates of potentially disabling mental health and neurological/chronic pain conditions, as well as obesity and other liver conditions (nonhepatitis), compared to CMBs.
Conclusion: This is the first systematic look at chronic disease burden in the transgender population using Medicare FFS claims data. We found that TMBs experience multiple chronic conditions at higher rates than CMBs, regardless of Medicare entitlement. TMBs under age 65 show an already heavy chronic disease burden which will only be exacerbated with age.
This doesn’t sound good for us. Are we a bunch of hypochondriacs?

Why do we have higher than the general population?

The study didn’t go in to the causes but I can see the opposition using this data against us.

Just a quick look at the medical problems indicates that many of them are stress related disorders and we know from other studies that the pressure that society puts on us to conform is one of the causes of stress in our lives.

Many of other medical problems are typical of low income or marginalized communities.

One other of the chronic conditions that caught my attention was autism spectrum disorder. Is it because of being missed diagnosed? Did they mistake autism spectrum disorder for gender dysphoria or is it something in the brain construction prenatally?

Also, the study uses clinical samples rather than population based samples will overestimate pathology.

Update 9:02 AM Added last sentence.

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