Division of Neurology, Department of Pediatrics, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, CO, USA.
Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA.
Headache. 2021 Jul;61(7):1040-1050. doi: 10.1111/head.14171.
To summarize the unique aspects of managing headache in gender minorities and current research in this area including the potential relationship between gender-affirming hormone therapy (GAHT) and headache.
The study of headache in gender minorities is intrinsically important. Gender minorities are medically underserved, and their medical care to date has been limited by socioeconomic disadvantages including stigma and an unsupportive clinical environment. Despite the rising population of transgender and gender-diverse adults and youth, headache research has also been limited. Knowledge of hormonal effects on headache in cisgender patients raises the question of possible effects of GAHT on transgender patients.
METHODS/RESULTS: The manuscript is a narrative review of current best practices in treating transgender patients, including the use of appropriate terminology and ways to create a supportive environment. It also contains current guidelines on GAHT and reviews drug-drug interactions and secondary headache related to hormone therapy. We also review transgender headache research and related research on hormonal effects on headache in cisgender individuals.
Creating a supportive environment for transgender and gender-diverse patients and being knowledgeable about GAHT are key to providing quality headache care. This review identifies further research needs for this population including the epidemiology of headache disorders in sexual minorities and the potential effects of GAHT on headache disorders in transgender patients.
总结管理性别少数群体头痛的独特方面和该领域的当前研究,包括性别肯定激素治疗(GAHT)与头痛之间的潜在关系。
研究性别少数群体的头痛具有内在重要性。性别少数群体在医学上得不到充分服务,迄今为止,他们的医疗服务受到社会经济劣势的限制,包括耻辱感和不支持性的临床环境。尽管跨性别和性别多样化的成年人和青年人口不断增加,但头痛研究也受到限制。对顺性别患者激素对头痛影响的了解提出了 GAHT 对跨性别患者可能产生影响的问题。
方法/结果:本文是对治疗跨性别患者的当前最佳实践的叙述性综述,包括使用适当的术语和创造支持性环境的方法。它还包含关于 GAHT 的当前指南,并回顾了药物相互作用和与激素治疗相关的继发性头痛。我们还回顾了跨性别头痛研究以及顺性别个体中激素对头痛影响的相关研究。
为跨性别和性别多样化患者创造支持性环境并了解 GAHT 是提供优质头痛护理的关键。本综述确定了该人群的进一步研究需求,包括性少数群体头痛障碍的流行病学以及 GAHT 对跨性别患者头痛障碍的潜在影响。