Cross-Sectional Analysis of Transgender Individuals Undergoing Endocrine Affirmative Care in the Texas Panhandle

Abstract

Abstract

Background:  Over the past decade, the number of individuals seeking affirmative transgender care has risen worldwide. Most research has originated from urban centers. Considerably less is known about health and psychosocial needs that transgender persons encounter in rural areas. 

Objective:  We sought to characterize individuals with gender dysphoria seeking endocrine gender-affirming care at a single university center located in a predominately rural locale.

Methods: A retrospective cross-sectional chart review and analysis was conducted of individuals seeking gender-affirming healthcare between 2009 and 2023. A total of 102 records were retrieved and evaluated using a 32-item checklist.

Results: The number of individuals seeking gender affirming healthcare over the 14-year timespan has increased (p < 0.001), especially in the last three years.  The average age at presentation was 22.2 (95% CI 20.6-23.9) years with a range of 9-69 years.  40.2% identified as transfemale and 59.8% as transmale. Many patients travel over 100 miles each way for care. 75.5% were white/Caucasian and 12.7% expressed interest in fertility preservation.  A family history of gender dysphoria was reported in 9 patients (8.8%).  No detransitioners have been identified.

Conclusions: The number of individuals seeking transgender care in this relatively rural area of Texas continues to grow. Regional healthcare providers should understand specific needs and barriers to medical and psychological care associated with this historically underserved and marginalized population. 

Abbreviations:  Transgender (TG), gender dysphoria (GD), Texas Tech University Health Sciences Center School of Medicine at Amarillo, Texas (TTUHSC-Amarillo), World Professional Association of Transgender Health (WPATH), American Society for Reproductive Medicine (ASRM), Lesbian, gay, bisexual, transgender (LGBT), Total laparoscopic hysterectomy with bilateral salpingo-oophorectomy (TLH-BSO), Gonadotropin releasing hormone analog (GnRHa), Pre-exposure prophylaxis (PreP).