Considerations for the care of transgender patients in orthopaedics and sports medicine: a narrative review.

IF 11.6 1区医学 Q1 SPORT SCIENCES

British Journal of Sports Medicine Pub Date : 2024-09-09 DOI:10.1136/bjsports-2023-107703

Madison Hayes-Lattin, Laura M Krivicich, Jack T Bragg, Ashley Rogerson, Matthew J Salzler

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引用次数: 0

Abstract

Orthopaedic and sports medicine clinicians can improve outcomes for transgender patients by understanding the physiological effects of gender-affirming hormone therapy (GAHT). This narrative review investigated the role of GAHT on bone mineral density, fracture risk, thromboembolic risk, cardiovascular health and ligament/tendon injury in this population. A search from the PubMed database using relevant terms was performed. Studies were included if they were levels 1-3 evidence. Due to the paucity of studies on ligament and tendon injury risk in transgender patients, levels 1-3 evidence on the effects of sex hormones in cisgender patients as well as basic science studies were included for these two topics. This review found that transgender patients on GAHT have an elevated fracture risk, but GAHT has beneficial effects on bone mineral density in transgender women. Transgender women on GAHT also have an increased risk of venous thromboembolism, stroke and myocardial infarction compared with cisgender women. Despite these elevated risks, studies have found it is safe to continue GAHT perioperatively for both transgender women and men undergoing low-risk operations. Orthopaedic and sports medicine clinicians should understand these unique health considerations for equitable patient care.

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骨科和运动医学中变性患者护理的考虑因素：叙述性综述。

骨科和运动医学临床医生可以通过了解性别确认激素疗法（GAHT）的生理效应来改善变性患者的治疗效果。这篇叙述性综述调查了 GAHT 对变性人骨矿密度、骨折风险、血栓栓塞风险、心血管健康和韧带/肌腱损伤的影响。我们使用相关术语在 PubMed 数据库中进行了搜索。证据级别为 1-3 级的研究均被纳入。由于有关变性患者韧带和肌腱损伤风险的研究较少，因此针对这两个主题纳入了有关性激素对顺性患者影响的 1-3 级证据以及基础科学研究。该综述发现，使用 GAHT 的变性患者骨折风险升高，但 GAHT 对变性女性的骨矿物质密度有益。使用 GAHT 的变性女性与同性女性相比，静脉血栓栓塞、中风和心肌梗死的风险也会增加。尽管存在这些高风险，但研究发现，对于接受低风险手术的变性女性和男性来说，在围手术期继续使用 GAHT 是安全的。骨科和运动医学临床医生应该了解这些独特的健康考虑因素，以便为患者提供公平的护理。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

British Journal of Sports Medicine 医学-运动科学

CiteScore

27.10

自引率

4.90%

发文量

217

审稿时长

3-8 weeks

期刊介绍： The British Journal of Sports Medicine (BJSM) is a dynamic platform that presents groundbreaking research, thought-provoking reviews, and meaningful discussions on sport and exercise medicine. Our focus encompasses various clinically-relevant aspects such as physiotherapy, physical therapy, and rehabilitation. With an aim to foster innovation, education, and knowledge translation, we strive to bridge the gap between research and practical implementation in the field. Our multi-media approach, including web, print, video, and audio resources, along with our active presence on social media, connects a global community of healthcare professionals dedicated to treating active individuals.