Abstract 198: Cardiovascular Outcomes, Behavioral Risk Factors, And Health Insurance In Transgender Population In The United States Of America: Analysis From The 2020 Behavioral Risk Factor Surveillance Survey

Background: There is paucity of clinical data regarding the health and cardiovascular (CV) outcomes of transgender (TG) population. Our aim was to determine the association of CV outcomes (and behavioral risk factors) with being TG in the USA.

Methods: We utilized Centers for Disease Control’s Behavioral Risk Factor Surveillance Survey (BRFSS) 2020 to determine responders who identified as TG. Non-TG (Cis gender) were also identified and used as controls. Behavioral risk factors such as history of smoking, lack of exercise, and heavy alcohol consumption (adult men having >14 drinks/week and adult women having >7 drinks/week) were measured. CV outcomes such as stroke, myocardial infarction (MI) and stable angina (SA) were noted. Lack of health insurance and college education were also analyzed. Data was studied in STATA 15 and multivariate logistic regression was used to estimate adjusted odds ratios (AOR) reported with p-value (significance=<0.05).

Results: There were 401,958 individuals in this survey. 1017 (0.25%) and 235887 (58.7%) were TG and cis genders respectively. There was a significant association of being TG and reporting stroke (AOR 1.87, [1.71-1.92], p=0.002) and MI (AOR 1.45, [1.39-1.55], p=0.003) compared to Cis genders. Association of TG population with reporting SA was statistically insignificant (p=0.66). TG group was also more likely to not have exercised in the past 30 days (AOR 2.71, [2.51-2.89], p=0.009). Heavy alcohol consumption in past 30 days was significantly higher in TG group (AOR 1.36, [1.21-1.44], P=0.002) compared to Cis genders. There was no significant association of smoking noted (p=0.5). TG population had higher odds of reporting depression (AOR 1.53, [1.50-1.61], p<0.001) compared to Cis genders. They were also more likely to not have health insurance (AOR 0.44, [0.36-0.71], p<0.002), and lack college education (AOR 0.53, [0.50-0.81], p<0.003).

Conclusion: Transgender population reports higher rates of cardiovascular diseases (stroke and MI), depressive disorder and heavy alcohol consumption. They are also more likely to not exercise, lack basic health insurance and college education contributing to worse clinical outcomes.