Project Name:
Comparative Risks and Benefits of Gender Reassignment Therapies

Principal Investigator:
Michael Goodman, MD MPH

Principal Investigator Contact Information:
mgoodm2@emory.edu

Principal Investigator institution:
Emory University

Funder
PCORI

Funding Period:
05/2013 – 04/2016

Abstract:
The goal of this study is to understand the short- and long-term health issues among transgender persons who had or are planning to have a sex change treatment. Members of the transgender community and their doctors express concerns about mental and physical health problems in this group of people; however, large studies of transgender persons in the United States have not been conducted. This project is an electronic medical record based study evaluating a group of 6,500 transgender individuals, whose care is covered by the Veterans Administration (nationally) or by Kaiser Permanente (in Georgia and in Northern and Southern California). In this study, we will compare frequencies of various diseases and deaths from various causes in transgender persons and separately in those who request female-to-male and male-to-female sex change to similar measures in a sample of men and women who are not transgender and are of the same age and race. We will also compare health problems by treatment categories (e.g., no medical treatment, versus treatment with hormones only, versus hormones plus surgery). The proposed project will be carried out by a team that includes experts in chronic and infectious diseases, mental disorders, and sexual minority health issues. All of the project activities will be implemented in consultation with the study advisors who will serve as advocates for the transgender community. This will likely be the largest study of transgender persons available to date, and the first study of its kind conducted in the United States.

Grant Number:
N/A

Participating Sites:               
Emory University
Kaiser Permanente Georgia
Kaiser Permanente Northern California
Kaiser Permanente Southern California
The Veterans Health Administration

Investigators:
Michael Goodman
Ashli Owen-Smith
Dennis Tolsma
Enid Hunkeler
Virginia Quinn
Douglas Roblin
Theresa Gillespie

Major Goals:
The goal of this study is to understand the short- and long-term health issues among transgender persons who had or are planning to have a sex change treatment.

Description of study sample:
6,500 transgender individuals, whose care is covered by the Veterans Administration (nationally) or by Kaiser Permanente (in Georgia and in Northern and Southern California).

Current Status:  
11/16: No-cost extension; data analysis.

Study Registration:
HSRP20143115

Publications:
Collin L, Reisner SL, Tangpricha V, Goodman M. Prevalence of Transgender Depends on the "Case" Definition: A Systematic Review. J Sex Med. 2016 Apr;13(4):613-26. doi: 10.1016/j.jsxm.2016.02.001. Epub 2016 Mar 25.

Holz LE, Goodman M. Epidemiology of advanced prostate cancer: overview of known and less explored disparities in prostate cancer prognosis. Curr Probl Cancer. 2015 Jan-Feb;39(1):11-6. doi: 10.1016/j.currproblcancer.2014.11.003. Epub 2014 Nov 26.

Reisner SL, Deutsch MB, Bhasin S, Bockting W, Brown GR, Feldman J, Garofalo R, Kreukels B, Radix A, Safer JD, Tangpricha V, TʼSjoen G, Goodman M. Advancing methods for US transgender health research. Curr Opin Endocrinol Diabetes Obes. 2016 Apr;23(2):198-207. doi: 10.1097/MED.0000000000000229.

Roblin D, Barzilay J, Tolsma D, Robinson B, Schild L, Cromwell L, Braun H, Nash R, Gerth J, Hunkeler E, Quinn VP, Tangpricha V, Goodman M.  A novel method for estimating transgender status using electronic medical records. Ann Epidemiol. 2016 Mar;26(3):198-203. doi: 10.1016/j.annepidem.2016.01.004. Epub 2016 Feb 4.

Resources:
N/A

Lessons Learned:
We are currently in the data analysis phase and thus no results are available to report.

What’s next?
Data analysis, publication and presentation of findings; planning for subsequent grant proposal to fund a follow-up study.