EB Fast Charged Ep. 6 LGBTQ+

Join me and gain insight into what the research says when it comes to the the LGBTQ+ community and endometriosis.

Transgender and gender diverse people with endometriosis: A perspective on affirming gynaecological care. Womens Health (Lond). 2024 Jan-Dec;20:17455057241251974.  https://pubmed.ncbi.nlm.nih.gov/38742674/

Prevalence of pelvic pain in transgender individuals on testosterone. J Sex Med. 2023 Nov 30;20(12):1459-1465. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10079239/

Breakthrough Bleeding in Transgender and Gender Diverse Adolescents and Young Adults on Long-Term Testosterone. J Pediatr Adolesc Gynecol. 2021 Oct;34(5):706-716. https://pubmed.ncbi.nlm.nih.gov/33910088/

Endometriosis in transmasculine individuals. Reprod Fertil. 2022 Apr 20;3(2):C7-C10. https://pubmed.ncbi.nlm.nih.gov/35706580/

 Sexual orientation and gynecologic medical care: A cross-sectional study with Brazilian women. Int J Gynaecol Obstet. 2022 May;157(2):458-465. https://pubmed.ncbi.nlm.nih.gov/34418094/

Website endobattery.com

Chapters

• 0:01 Endometriosis and Gender Identity Research
• 10:53 Inclusive Endometriosis Care for LGBTQ

Transcript

Speaker 1: 0:01

Welcome to Endobattery Fast Charged, a series dedicated to keeping you informed and empowered in the realm of endometriosis. Teaming up with board-certified patient advocates, we bring you the latest articles, research and insights to equip you with accurate information and a deeper understanding. Whether you're expanding your knowledge, staying updated or seeking clarity, you're in the right place. I'm your host, Alana, and this is IndoBattery Fast Charged charging and empowering your life with knowledge. Welcome back to IndoBattery Fast Charged.

Speaker 1: 0:36

Ah, it's June, the month of rainbows, parades and unapologetic fabulousness. Yes, it's Pride Month the perfect time to don your most colorful attire and celebrate people in all their glorious forms. But amidst the glitter and festivities, let's take a moment to shine a spotlight on some compelling research about endometriosis and its impacts on the LGBTQ plus community. It's like a fabulous double feature Not only are we highlighting the often overlooked community, but we're also diving into intriguing studies that challenge how we define and treat endometriosis. Remember, though, these research findings are more like a good gossip session, full of juicy correlations, but not necessarily spilling the tea on direct causations. So let's get ready to learn and push for some inclusive change.

Speaker 1: 1:23

In a recent study titled Transgender and Gender Diverse People with Endometriosis, a Perspective and Affirming Gynecological Care has reaffirmed a critical but often overlooked fact Transgender and gender diverse individuals assigned female at birth experience conditions like chronic pelvic pain significantly more than cisgender women. For instance, the prevalence of chronic pelvic pain significantly more than cisgender women. For instance, the prevalence of chronic pelvic pain amongst transgender and gender diverse people ranges from between 51% and 72%, compared to about 26% among cisgender women. This discrepancy is particularly evident with endometriosis, which affects many, but is compounded by the additional barriers to care faced by trans and gender diverse individuals. These barriers include discrimination within healthcare settings, a lack of knowledge among doctors regarding transgender care and pervasive assumptions that all gynecological patients are women. Such factors lead to underdiagnosis and inadequate treatment for transgender and gender-diverse individuals with endometriosis. Despite the high prevalence of this condition amongst them, there is a significant gap in research exploring effective management options tailored to their needs. This study emphasizes the urgent need for affirming gynecological care for transgender and gender-diverse patients with endometriosis. It highlights the critical importance of bias reduction and enhancing training for healthcare providers to ensure that these patients receive the care they need and deserve. This call to action is not meant to downplay the challenges faced by cisgender women with endometriosis, who also struggle with lengthy times to diagnosis and limited treatment options. However, it underscores the additional hurdles that trans and non-binary individuals must overcome to seek care. This illuminates the pressing need for more inclusive healthcare practices and dedicated research to address the unique challenges faced by transgender and gender diverse individuals with endometriosis. By fostering a more understanding and knowledgeable healthcare environment, we can begin to bridge the gap in care and ensure that all patients, regardless of gender identity, receive the treatment and support they need.

Speaker 1: 3:33

In the study titled the Prevalence of Pelvic Pain in Transgender Individuals on Testosterone, published in the Journal of Sexual Medicine, builds significantly on the prior framework established by earlier research. One key study involving 280 patients who had been on testosterone for at least a year, found a noteworthy correlation between the occurrence of pelvic pain and conditions such as dysmenorrhea, endometriosis and ovarian cysts. The foundational research highlights those who experience pelvic pain while on testosterone are more likely to have these underlying conditions, suggesting a complex interplay between hormone therapy and pre-existing gynecological issues. In a recent study, researchers delved deeper into the phenomenon, examining the broader cohort of transgender individuals undergoing testosterone therapy. The findings are compelling, revealing that a substantial number of these individuals report pelvic pain, which not only affects their physical well-being but also their quality of life. This pain is often linked to the aforementioned conditions, further corroborating the earlier findings and emphasizing the need for comprehensive healthcare that addresses both hormonal and gynecological health in transgender patients.

Speaker 1: 4:43

What makes this study particularly thought-provoking is its exploration in the reasons behind this pain. It suggests that testosterone therapy, while essential for gender-affirming treatment, might exacerbate or bring to light lenient gynecological issues. This underscores the importance of a multidisciplinary approach to transgender healthcare, which endocrinologists, gynecologists and mental health professionals collaborate to provide holistic care. The study advocates for routine screening and proactive management of pelvic pain and related conditions in transgender patients on testosterone, aiming to improve their overall health outcome. Furthermore, this study challenges the medical community to consider a broader implication of hormone therapy beyond its primary purpose of gender affirmation. It opens up a dialogue about the necessity for personalized medicine, where treatment plans tailor not just to the gender identity of the patient, but also to their unique medical history and potential risks. By integrating these insights, healthcare providers can better support the transgender community, ensuring that the benefits of testosterone therapy are maximized while minimizing any adverse effects.

Speaker 1: 5:54

This next study looks at the occurrence of breakthrough bleeding in transgender and gender-diverse adolescents and young adults undergoing long-term testosterone therapy and its significant concern in the medical community gender and gender diverse, adolescents and young adults on long-term testosterone. Researchers identified a higher incidence of breakthrough bleeding among this population, particularly noting an increased prevalence in those with, or more susceptible to, endometriosis. This correlation suggests that underlying gynecological conditions may influence the efficiency of testosterone therapy managing menstrual suppression, raising important questions about individualized treatment plans. This finding underscores the complexity of providing effective gender-affirming care, as it highlights the need for healthcare providers to consider pre-existing conditions like endometriosis when prescribing and managing testosterone therapy. It prompts further investigation into tailored approaches that can address both gender dysphoria and concurrent gynecological issues, as the previous study indicated, ensuring comprehensive care that respects and meets the unique needs of transgender and gender diverse patients. The study opens up a critical dialogue about the interplay between hormone therapy and reproductive health, advocating for a more nuanced and informed approach in medical practice.

Speaker 1: 7:21

In this next research effort led by Cecile Ferrando from the Center of Urogynecology and Pelvic Reconstructive Surgery at the Women's Health Institute and Center for LGBT Care at the Cleveland Clinic, titled Endometriosis in Transmasculine Individuals significant findings emerged regarding the experiences in Transmasculine Individuals. Significant findings emerged regarding the experiences of transmasculine individuals undergoing hysterectomy. The study revealed that many transmasculine patients seek hysterectomy, not only as a means of gender affirmation, but also to alleviate pelvic pain. The dual purpose highlights the multifaceted benefits of the surgery for this population. Ferrando's research uncovered a striking prevalence of endometriosis among transmasculine individuals. In the study, 32% of patients who reported pelvic pain during their preoperative consultations were found to have endometriosis. Interestingly, endometriosis was also diagnosed in 22% of patients who had not reported any pelvic pain. This suggests that endometriosis may be more common and less symptomatic in transmasculine individuals than previously understood. The implications of these findings are significant for both healthcare providers and transmasculine patients. For providers, it underscores the importance of thorough preoperative evaluations and a deeper consideration of underlying conditions like endometriosis, even in the absence of reported symptoms. For patients, it highlights an additional potential benefit of hysterectomy that goes beyond gender affirmation, offering relief from a condition they may not even realize they have. Overall, Ferrando's study enriches our understanding of the healthcare needs of transmasculine individuals. It emphasizes the need for comprehensive care approaches that address both gender dysphoria and potential gynecological issues, ensuring that patients receive the full spectrum of care they need for their overall well-being.

Speaker 1: 9:13

In this next 2022 publication called Sexual Orientation and Gynecologic Medical Care, a cross-sectional study with Brazilian women explores the relationship between sexual orientation and gynecologic medical care. Amongst Brazilian women, the study found notable differences in the prevalence of certain gynecologic conditions based on sexual orientation. Specifically, endometriosis and vaginismus were more common amongst bisexual women, whereas polycystic ovarian syndrome, or PCOS, were more frequently diagnosed in lesbians. These findings highlight the unique health challenges faced by sexual minority women compared to their heterosexual counterparts. Interestingly, the study also reveals the distinct health characteristics in lesbian and bisexual women. Both groups showed different patterns and occurrence of endometriosis, vaginismus and PCOS, suggesting that sexual orientation might influence the risk or diagnosis of these conditions.

Speaker 1: 10:11

Despite these differences, a common thread was dissatisfaction and discomfort both lesbians and bisexual women reported regarding gynecologic care they received. This indicates a potential gap in the medical community's ability to effectively address and treat the needs of sexual minority women. The discomfort and dissatisfaction with medical treatment reported by lesbian and bisexual women are unsurprising, but concerning lesbian and bisexual women are unsurprising. But concerning these feelings may stem from a lack of understanding or sensitivity from healthcare providers, leading to inadequate or inappropriate care. The study's findings call for improved training and awareness among gynecologists and other healthcare professionals to better support the unique needs of sexual minority women.

Speaker 1: 10:53

Overall, this research underscores the importance of recognizing and addressing the specific gynecologic health needs of lesbian and bisexual women. It also emphasizes the necessity for a more inclusive and sensitive healthcare environment that can provide appropriate care for all women, regardless of their sexual orientation. The study serves as a critical reminder of the ongoing disparities in healthcare and the need for continuous efforts to bridge these gaps. If you thought that was all the fascinating articles on this topic, think again, because next week we're going to revisit this with more detail, as it pertains to what it means for not only the LGBTQ plus community, but endometriosis as a whole. Until next time, keep advocating for inclusive endometriosis care. Bye.