Vin Tangpricha

Background: Prevalent and incident heart failure (HF) and its comorbidities have not been characterized in transgender and gender‐diverse (TGD) populations. This study determines the prevalence and incidence of HF phenotypes by gender identity. Methods: A retrospective cohort analysis was performed using deidentified administrative claims from the Optum Labs Data Warehouse (2006–2022). TGD adults and a sample of demographically similar cisgender comparators were identified using a validated algorithm, and gender identity was categorized as cisgender man, cisgender woman, transmasculine, transfeminine, or unclassified TGD. Prevalent and incident HF, including systolic, diastolic, and unclassified phenotypes, were assessed using diagnosis codes. Multivariable logistic and Cox regression models adjusted for age and comorbidities evaluated associations between gender identity and HF. Results: In this cohort of 57 471 TGD individuals and 298 213 demographically similar cisgender comparators, 17 898 TGD people (31.1%) were transmasculine, 9652 (16.8%) were transfeminine, and 29 921 (52.1%) had unclassified TGD identity. In adjusted models, transmasculine people experienced less prevalent systolic HF than cisgender men (odds ratio, 0.37 [98.75% CI, 0.17–0.83]) and women (odds ratio, 0.42 [98.75% CI, 0.19–0.92]). Transmasculine people experienced less incident diastolic HF relative to cisgender men (hazard ratio [HR], 0.65 [98.75% CI, 0.51–0.82]) and women (HR, 0.66 [98.75% CI, 0.52–0.83]). Transfeminine people experienced more incident diastolic HF than cisgender men (HR, 1.36 [98.75% CI, 1.05–1.77]) and women (HR, 1.38 [98.75% CI, 1.07–1.79]). Conclusions: Prevalent systolic HF and incident diastolic HF differed by gender identity after adjustment for age and clinical comorbidities. Further research is needed to identify underrecognized sex‐ and gender‐based HF risk modifiers.

This study aimed to identify barriers and facilitators influencing transgender individuals’ participation in teledermatology-based acne research and their perceptions of artificial intelligence use in acne research. This was a qualitative study conducted between 2021 and 2023. Transgender and gender diverse individuals who received gender-affirming hormone therapy and had acne were recruited from a public safety-net hospital and from academic endocrinology and dermatology clinics. Semi-structured interviews exploring factors influencing teledermatology-based acne research participation were analyzed using thematic analysis. Among 32 participants, 17 (53%) identified as transgender men, 11 (34%) as transgender women, and 4 (13%) as non-binary or other gender identities. Mild or lower acne severity was reported by 21 (66%) participants, while 11 (34%) reported moderate-to-severe acne. Access to equipment and comfort in photographing sensitive areas determined capability of participation in hypothetical teledermatology research. Accessibility, flexibility, and reduced transportation cost of remote research, and in-clinic recruitment from established clinicians presented opportunities for participation. Motivating factors included trust in research team members, privacy concerns, and improving acne treatment for transgender individuals. Perspectives on artificial intelligence were mixed and included concerns regarding security and potential for bias. Teledermatology offers opportunity to improve recruitment and retention of transgender individuals in acne research. Incorporating perspectives of transgender individuals can inform the design of future teledermatology research on acne in the context of gender-affirming hormone therapy.

Cystic fibrosis-related bone disease (CFBD) is a common endocrinopathy in people living with cystic fibrosis (CF) that is complex and multifactorial in origin. People with CF experience high rates of progressive bone density loss and increased fracture risk. Focus on prevention and treatment of CFBD is of increasing importance in a now aging CF population. This review will discuss current practices in CFBD, gaps in knowledge, and potential future studies with the goal of advancing the clinical care of patients with CFBD.