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. 2022 Mar 24;107(4):e1549-e1557.
doi: 10.1210/clinem/dgab832.

Is There a Link Between Hormone Use and Diabetes Incidence in Transgender People? Data From the STRONG Cohort

Noreen Islam  1 , Rebecca Nash  2 , Qi Zhang  2 , Leonidas Panagiotakopoulos  1 , Tanicia Daley  1 , Shalender Bhasin  3   4 , Darios Getahun  5   6 , J Sonya Haw  1 , Courtney McCracken  7 , Michael J Silverberg  8 , Vin Tangpricha  1   9 , Suma Vupputuri  10 , Michael Goodman  2
Affiliations

Is There a Link Between Hormone Use and Diabetes Incidence in Transgender People? Data From the STRONG Cohort

Noreen Islam et al. J Clin Endocrinol Metab. .

Abstract

Background: Risk of type 2 diabetes mellitus (T2DM) in transgender and gender diverse (TGD) persons, especially those receiving gender-affirming hormone therapy (GAHT) is an area of clinical and research importance.

Methods: We used data from an electronic health record-based cohort study of persons 18 years and older enrolled in 3 integrated health care systems. The cohort included 2869 transfeminine members matched to 28 300 cisgender women and 28 258 cisgender men on age, race/ethnicity, calendar year, and site, and 2133 transmasculine members similarly matched to 20 997 cisgender women and 20 964 cisgender men. Cohort ascertainment spanned 9 years from 2006 through 2014 and follow-up extended through 2016. Data on T2DM incidence and prevalence were analyzed using Cox proportional hazards and logistic regression models, respectively. All analyses controlled for body mass index.

Results: Both prevalent and incident T2DM was more common in the transfeminine cohort relative to cisgender female referents with odds ratio and hazard ratio (95% CI) estimates of 1.3 (1.1-1.5) and 1.4 (1.1-1.8), respectively. No significant differences in prevalence or incidence of T2DM were observed across the remaining comparison groups, both overall and in TGD persons with evidence of GAHT receipt.

Conclusion: Although transfeminine people may be at higher risk for T2DM compared with cisgender females, the corresponding difference relative to cisgender males is not discernable. Moreover, there is little evidence that T2DM occurrence in either transfeminine or transmasculine persons is attributable to GAHT use.

Keywords: cohort study; transgender; type 2 diabetes mellitus.

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Figures

Figure 1.
Figure 1.
Cumulative incidence curves comparing incidence of T2DM in TGD participants and their matched referents. Top row shows results for the overall TF cohort followed from the index date (left panel) and for the TF cohort followed from HT initiation date (right panel). Bottom row shows results for the overall TM cohort followed from the index date (left panel) and for the TM cohort followed from HT initiation date (right panel). Abbreviations: CF, cisgender female; CM, cisgender male; HT, hormone therapy; T2DM, type 2 diabetes mellitus; TF, transfeminine; TGD, transgender and gender nonconforming; TM, transmasculine.
See this image and copyright information in PMC

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