'Neurologic Care for Transgender and Gender-Diverse People: Clinical Implications'

 Gwen Zeigler, DO https://orcid.org/0009-0007-8310-2449, Cole A. Harrington, MD, PhD https://orcid.org/0000-0001-6352-8687, Nicole Rosendale, MD https://orcid.org/0000-0002-2431-5440, Christos Ganos, MD https://orcid.org/0000-0001-8077-8530, Valeria Roldan, MD https://orcid.org/0009-0009-6020-2791, Anna Pace, MD https://orcid.org/0009-0007-7869-251X, Sasha Alick-Lindstrom, MD https://orcid.org/0000-0002-5859-0862, Casey Orozco-Poore, MD https://orcid.org/0000-0003-0011-2048, Wissam Deeb, MD https://orcid.org/0000-0003-3794-8359, Margaret L. Hansen, PharmD https://orcid.org/0009-0005-7276-352X, and Z Paige L'Erario, MD, MSW

doi.org/10.1212/CPJ.0000000000200332

Abstract

Purpose of Review

To summarize the literature on neurologic care for transgender and gender-diverse (TGD) people and provide implications for clinical practice.

Recent Findings

There are limited data on the frequency and management of neurologic conditions among TGD people. TGD people have a higher prevalence of various neurologic conditions compared with cisgender or general population cohorts, including migraine, subjective cognitive decline, sleep disturbances, functional disorders, and cerebrovascular disease. Gender-affirming hormone therapy interacts with commonly prescribed neurologic medications and increases stroke risk among transfeminine people. Sex hormones and sex chromosomes may play a role in neurodegeneration and disability progression in neuroimmunologic diseases. Clitoral reduction surgeries on intersex children can cause neurologic disability and sexual dysfunction in adulthood. Socioeconomic disparities among TGD people contribute to health care barriers.

Summary

Neurologists should consider the unique experiences and health care needs of TGD people in their clinical practice and research protocols.

https://www.neurology.org/doi/10.1212/CPJ.0000000000200332