According to a study published in the September 25, 2024, online issue, LGBTQ+ people may be more likely to experience negative brain health consequences, including a higher risk of dementia and depression later in life, than people who are cisgender and straight. Neurology®the medical journal of the American Academy of Neurology. These results do not prove that sexual or gender diversity causes neurological diseases, they only show a connection.
LGBTQ+ refers to people who are lesbian, gay, bisexual, transgender and non-binary, plus other people who are sexually or gender diverse. Sexual diversity refers to people whose sexual orientation is different from heterosexual people, including lesbian, gay or bisexual people. Gender diversity refers to people whose gender identity does not correspond to the sex they were assigned at birth, including transgender and non-binary people. Cisgender refers to individuals whose gender identity corresponds to their assigned sex at birth.
In a world that increasingly recognizes the critical role of equitable health care, it remains concerning how little is known about the health disparities faced by LGBTQ+ people. Our study looked at this group, which has been historically underrepresented in neurological research, and found that they were at increased risk for adverse brain health outcomes.”
Shufan Huo, MD, PhD, study author at the Yale School of Medicine in New Haven, Connecticut
For the study, researchers evaluated data from 393,041 people with an average age of 51 years. Of the total group, 353,409 were cisgender and heterosexual people, and 39,632 were LGBTQ+ people.
Researchers evaluated electronic medical records and self-reported data to identify a composite score of the following neurological conditions: dementia, late-life depression, and stroke. They then evaluated each disease separately and looked at all subgroups of the LGBTQ+ participants.
A total of 21,091 people had a neurological disease. Of these, 11,553 people had depression later in life, 6,605 people had a stroke and 2,933 people had dementia.
After adjusting for factors that could influence the risk of these three neurological conditions, such as age, smoking or high blood pressure, researchers found that LGBTQ+ people were 15% more likely to develop negative brain health outcomes under these conditions, compared to people who identify as cisgender and straight.
Researchers also found that LGBTQ+ people had a higher risk of dementia and depression later in life, 14% and 27% respectively, than people who were cisgender and straight.
“Our findings underscore the need for further research that focuses on health care disparities affecting the LGBTQ+ community,” Huo said. “Possible reasons for these differences may include discrimination, stress, access to health care, and policy and legal factors.”
When we looked at stroke, researchers only found a higher risk for transgender women, who were 68% more likely to have a stroke than cisgender women.
A limitation of the study was that it did not examine the causes and mechanisms behind the inequalities faced by LGBTQ+ people. For example, the study did not look at gender-affirming hormone therapy in transgender people, which could play a role in the increased risk of stroke in transgender women.
The study was supported by the German Research Foundation.
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Magazine reference:
Huo, S., et al. (2024) Brain health outcomes in sexual and gender minority groups. Results of the All of Us Research Program. Neurology. doi.org/10.1212/WNL.0000000000209863.