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. 2021 Jan;17(1):16-26.
doi: 10.1007/s13181-020-00789-1. Epub 2020 Jun 17.

Characteristics of Transgender Patient Cases Managed by a Toxicologist: an Analysis of the Toxicology Investigator's Consortium (ToxIC) Registry: January 2017-June 2019

Ryan M Surmaitis  1   2 , Marna Rayl Greenberg  3 , Natalie E Ebeling-Koning  1 , Phillip M Grenz  1 , Cody R McWhirter  1 , Beth A Careyva  4 , Judith N Sabino  5 , Matthew D Cook  1   2 , Robert D Cannon  1   2 , Andrew L Koons  1   2 , Kenneth D Katz  1   2 , Hope Kincaid  6 , Lexis T Laubach  1 , Gillian A Beauchamp  1   2 ; toxicology investigator’s consortium (ToxIC)
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Characteristics of Transgender Patient Cases Managed by a Toxicologist: an Analysis of the Toxicology Investigator's Consortium (ToxIC) Registry: January 2017-June 2019

Ryan M Surmaitis et al. J Med Toxicol. 2021 Jan.

Abstract

Introduction: The Toxicology Investigators Consortium (ToxIC) database, created in 2010 by the American College of Medical Toxicology (ACMT), compiles data recorded by medical toxicologists. In January 2017, the data field for transgender (and if transgender, male-to-female or female-to-male) was added to the ToxIC form. Little is known regarding trends in poisonings among transgender patients. We sought to review consultations managed by a bedside toxicologist and provide descriptive data in trends among types of exposures within the transgender demographic.

Methods: A retrospective ToxIC database evaluation of cases in which the patient identified as transgender were reviewed from January 2017-June 2019 and descriptive demographics reported.

Results: The registry contained 113 cases that involved transgender patients. Of those with complete data, 41 (36.6%) were male-to-female, 68 (60.7%) were female-to-male, and 3 (2.7%) identified as gender non-conforming. Of those with complete data, the most common reason for encounter was intentional use of a pharmaceutical drug (N = 97, 85.8%), of which 85 (87.6%) were classified as intentional pharmaceutical use intended for self-harm. Analgesics were the most common class of drugs used out of those reported (N = 24, 22%). Forty-six (90.2%) patients aged 13-18 with complete data were identified as encounters due to self-harm. Attempt at self-harm was the most common reason for intentional pharmaceutical encounter among the sample of transgender patients with complete data (N = 85, 87.6%); with female-to-male patients having an N = 53 (77.9%).

Conclusion: Among transgender patients in the ToxIC registry, the most common primary reason for the encounter was intentional use of a pharmaceutical drug intended for self-harm. In this small cohort, there were some age and transition differences in prevalence. These findings may inform poisoning prevention practices as well as sex- and gender-based management of patients in this vulnerable population.

Keywords: Drug misuse and abuse; ToxIC; Toxicological exposure; Transgender.

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Conflict of interest statement

None. The authors have no outside support information, conflicts or financial interest to disclose. This study, in part, was funded by an unrestricted grant, the Dorothy Rider Pool Trust for Health Research and Education community foundation grant (Grant Number 20121584-001). An abstract of this content, in part, was presented by Mikayla Hurwitz at the American College of Medical Toxicology Annual Scientific Meeting March 13-15, 2020 in New York, NY. The authors acknowledge her input in preparation and presentation of this abstract.

Figures

Fig. 1
Fig. 1
Primary reason for encounter flow diagram.
See this image and copyright information in PMC

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