Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Type 1 diabetes in transgender children and adults

Martin Lustick, MD
Conditions
April 30, 2021
Share
Tweet
Share

In the face of genetically engineered therapies for many cancers and the incredibly rapid development of effective vaccines for COVID-19, it’s easy to lose sight of the breadth and depth of unsolved puzzles in medical science. Many of these remaining mysteries may be at least partially resolved as we overcome the mind/body dichotomy. A fascinating example of this issue has emerged with recent evidence of the excessive prevalence of Type 1 diabetes (T1D) in transgender children and adults.

The earliest report of this association came in 2017 from a retrospective study in Belgium that revealed a 2.3-fold higher prevalence of T1D among 1,081 transgender adults, compared to the general population. In 2019, another retrospective study out of the University of Wisconsin looked at 749,284 patients between 10 and 21 years old over a 10-year period.  The prevalence of T1D proved to be 9.5 times greater in the gender dysphoric children than in the remainder of the population. Most recently, a group out of Boston Children’s Hospital reported a prevalence for T1D in their 1,014 transgender youth that is 5.11 times the general population. An additional interesting finding of the latter two studies was that children with gender dysphoria were diagnosed with T1D at a much younger age than the national average. The age of diagnosis in Boston and Wisconsin were 8.5 and 9.9 respectively, compared to the national average of 14.5.

Notably, the dual diagnosis patients across these studies varied. In Belgium, eight of the 10 were transgender women. In Boston, nine of 11 were transgender males, and in Wisconsin, there were three transgender males, three transgender females, one identifying as gender-fluid, and one as gender-neutral. Taking the three studies in aggregate, the correlation of T1D with gender dysphoria appears to exist equally for all transgender people.

The authors of these studies propose two potential explanations for this surprising correlation.  One is the possibility that people going to endocrinology clinics for T1D may be more likely to identify as gender dysphoric as many transgender and diabetes clinics are co-located. These transgender “friendly” locations may drive increased rates of transgender identification, resulting in the appearance of a correlation with T1D. To the extent there is truth in this hypothesis, it speaks to the importance of providers offering safe, non-judgmental clinical settings where labels are destigmatized, and patients are able to share this critically important information about themselves.

The second explanation for this finding is that the stress of gender dysphoria acts as a trigger for those with a genetic predisposition to T1D. One argument in favor of the stress as trigger theory, is that patients with T1D who underwent hormonal therapy (either suppression or augmentation) experienced an improvement in their HbA1c following the initiation of treatment.

Though much more work needs to be done to clearly identify the causal relationship between gender dysphoria and Type 1 diabetes, these studies challenge us to overcome our longstanding paradigm that views mind and body separately. Even the idea that the two interact with each other rather than exist as differing manifestations of one whole self should be called into question. To fully understand this and other medical mysteries before us, we may very well need to develop an entirely new vocabulary.

Martin Lustick is a physician and senior vice-president and principal, NextGen Healthcare.

Image credit: Shutterstock.com

Prev

What medical professionals can do to take climate action [PODCAST]

April 29, 2021 Kevin 0
…
Next

By jeopardizing privacy, did this physician meet patient satisfaction goals?

April 30, 2021 Kevin 2
…

Tagged as: Diabetes, Endocrinology

Post navigation

< Previous Post
What medical professionals can do to take climate action [PODCAST]
Next Post >
By jeopardizing privacy, did this physician meet patient satisfaction goals?

ADVERTISEMENT

More by Martin Lustick, MD

  • The claims data dilemma: 4 things to consider

    Martin Lustick, MD
  • The “wonder years” of health care

    Martin Lustick, MD
  • 3 ways interoperability will improve health care

    Martin Lustick, MD

Related Posts

  • a desk with keyboard and ipad with the kevinmd logo

    MKSAP: 45-year-old woman with type 2 diabetes mellitus

    mksap
  • Type 1 diabetes is no fun

    Ryan Ritchie
  • When should you prescribe statins for older adults?

    Kenneth Lin, MD
  • Stop treating doctors like school children

    Rebekah Bernard, MD
  • When celebrities attack children with food allergies

    Lianne Mandelbaum, PT
  • Should adults receive another dose of MMR?

    Roy Benaroch, MD

More in Conditions

  • Facing terminal cancer as a doctor and mother

    Kelly Curtin-Hallinan, DO
  • Why doctors must stop ignoring unintentional weight loss in patients with obesity

    Samantha Malley, FNP-C
  • Why hospitals are quietly capping top doctors’ pay

    Dennis Hursh, Esq
  • Why point-of-care ultrasound belongs in emergency department triage

    Resa E. Lewiss, MD and Courtney M. Smalley, MD
  • Why PSA levels alone shouldn’t define your prostate cancer risk

    Martina Ambardjieva, MD, PhD
  • Reframing chronic pain and dignity: What a pain clinic teaches us about MAiD and chronic suffering

    Olumuyiwa Bamgbade, MD
  • Most Popular

  • Past Week

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • America’s ER crisis: Why the system is collapsing from within

      Kristen Cline, BSN, RN | Conditions
    • Why timing, not surgery, determines patient survival

      Michael Karch, MD | Conditions
    • How early meetings and after-hours events penalize physician-mothers

      Samira Jeimy, MD, PhD and Menaka Pai, MD | Physician
  • Past 6 Months

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
  • Recent Posts

    • Beyond burnout: Understanding the triangle of exhaustion [PODCAST]

      The Podcast by KevinMD | Podcast
    • Facing terminal cancer as a doctor and mother

      Kelly Curtin-Hallinan, DO | Conditions
    • Online eye exams spark legal battle over health care access

      Joshua Windham, JD and Daryl James | Policy
    • FDA delays could end vital treatment for rare disease patients

      G. van Londen, MD | Meds
    • Pharmacists are key to expanding Medicaid access to digital therapeutics

      Amanda Matter | Meds
    • Why ADHD in women requires a new approach [PODCAST]

      The Podcast by KevinMD | Podcast

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

Leave a Comment

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • America’s ER crisis: Why the system is collapsing from within

      Kristen Cline, BSN, RN | Conditions
    • Why timing, not surgery, determines patient survival

      Michael Karch, MD | Conditions
    • How early meetings and after-hours events penalize physician-mothers

      Samira Jeimy, MD, PhD and Menaka Pai, MD | Physician
  • Past 6 Months

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
  • Recent Posts

    • Beyond burnout: Understanding the triangle of exhaustion [PODCAST]

      The Podcast by KevinMD | Podcast
    • Facing terminal cancer as a doctor and mother

      Kelly Curtin-Hallinan, DO | Conditions
    • Online eye exams spark legal battle over health care access

      Joshua Windham, JD and Daryl James | Policy
    • FDA delays could end vital treatment for rare disease patients

      G. van Londen, MD | Meds
    • Pharmacists are key to expanding Medicaid access to digital therapeutics

      Amanda Matter | Meds
    • Why ADHD in women requires a new approach [PODCAST]

      The Podcast by KevinMD | Podcast

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Leave a Comment

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...