Trans adults are twice as likely to die as cis adults, according to an analysis of almost 50 years of medical records from an Amsterdam gender clinic.
Trans women had particularly high risks of death, and are nearly three times more likely to die than cis women and twice as likely as cis men, with the most common causes including HIV-related illnesses, heart disease, lung cancer and suicide.
Trans men had similar mortality rates to cis men, but were twice as likely to die as cis women, especially from non-natural causes like suicide.
Published in the Lancet Diabetes & Endocrinology, the study authors said their findings show the need for improving social acceptance and healthcare for trans adults.
Researchers used the medical records of nearly 3,000 trans women and more than 1,600 trans men who were treated at the Amsterdam University Medical Center between 1972 and 2018, finding that the increased risk of mortality among trans adults compared to cis adults did not decrease over the almost five decades studied.
However, they cautioned against extrapolating the results of the study onto trans populations in other countries, pointing out that certain groups of trans people were excluded – including those who accessed trans healthcare under the age of 17, those who received puberty-blocking medication, and those who had taken both testosterone and oestragen hormone replacement therapy – and that 90 per cent of the study group were white.
Trans people more likely to die by suicide than cis people
While all of the trans adults included in the study were, or had at some point, taken hormone replacement treatment, the researchers said that this itself was not a driver of the health disparities observed. Most of the causes of increased death that the researchers identified, like suicide, are not a consequence of hormone treatment side-effects.
Trans adults are at a much higher risk of dying by suicide than their cis counterparts. A report by the Center for American Progress, a liberal think-tank based in Washington, DC, in May found that trans adults are five times more likely than straight, cis adults to have made at least one suicide attempt in their lifetime.
The elevated suicide risks for trans adults stem from social factors including family rejection, institutional discrimination, living in poverty, housing insecurity, criminalisation and a lack of access to gender-affirming healthcare.
The first author of the Amsterdam study, Christel de Blok, told Forbes that most of the suicides and deaths related to HIV in the almost 50 years of the study happened in the first couple of decades, “suggesting that greater social acceptance and access to support, and improved treatments for HIV, may have played an important role in reducing deaths related to these causes among transgender people in recent years”.
Suicide is preventable. Readers who are affected by the issues raised in this story are encouraged to contact Samaritans on 116 123 (www.samaritans.org), or Mind on 0300 123 3393 (www.mind.org.uk). Readers in the US are encouraged to contact the National Suicide Prevention Line on 1-800-273-8255.
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