Abstract
Research to assess the burden of non-communicable diseases (NCDs) among the transgender population needs to be prioritized given the high prevalence of chronic conditions and associated risk factors in this group. Previous cross-sectional studies utilized unmatched samples with a significant covariate imbalance resulting in a selection bias. Therefore, this cross-sectional study attempts to assess and compare the burden of NCDs among propensity score-matched transgender and cisgender population groups. This study analyzed Behavioral Risk Factor Surveillance System data (2017–2019) using complex weighting procedures to generate nationally representative samples. Logistic regression was fit to estimate propensity scores. Transgender and cisgender groups were matched by sociodemographic variables using a 1:1 nearest neighbor matching algorithm. McNemar, univariate, and multivariate logistic regression analyses were conducted among matched cohorts using R and SPSS version 26 software. Compared with the cisgender group, the transgender group was significantly more likely to have hypertension (31.3% vs. 27.6%), hypercholesteremia (30.8% vs. 23.7%), prediabetes (17.3% vs. 10.3%), and were heavy drinkers (6.7% vs. 6.0%) and smokers (22.4% vs. 20.0%). Moreover, the transgender group was more than twice as likely to have depression (aOR: 2.70, 95% CI 2.62–2.72), stroke (aOR: 2.52 95% CI 2.50–2.55), coronary heart disease (aOR: 2.77, 95% CI 2.74–2.81), and heart attack (aOR: 2.90, 95% CI 2.87–2.94). Additionally, the transgender group was 1.2–1.7 times more likely to have metabolic and malignant disorders. Differences were also found between transgender subgroups compared with the cisgender group. This study provides a clear picture of the NCD burden among the transgender population. These findings offer an evidence base to build health equity models to reduce disparities among transgender groups.
Highlights
In 2019, seven of the top ten leading causes of death worldwide were non-communicable diseases (NCDs) [1,2]
These findings offer an evidence base to build health equity models to reduce disparities among transgender groups
Adults compared with cisgender adults in the U.S This is concerning because Transgender and gender nonbinary (TGNB) people are less likely to seek out medical care due to fear of discrimination or harassment, a lack of health insurance, or cost of care
Summary
In 2019, seven of the top ten leading causes of death worldwide were non-communicable diseases (NCDs) [1,2]. These include heart disease, stroke, chronic obstructive pulmonary disease, lung cancers, dementia, diabetes, and kidney diseases [3]. 3.4 is to reduce death from NCDs by one-third through prevention and early detection by. The majority of NCD-associated deaths are preventable and can be reduced by controlling modifiable risk factors, including smoking tobacco, alcohol consumption, high salt intake, obesity, hypertension, and hyperglycemia. According to previous prediction modeling, 37 million deaths could be prevented or delayed in a 15-year time frame by prioritizing the reduction in risk factors through a coordinated approach [6]
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