Thread by @JasmineSchipp

I'm now attending the symposium at #ADA2022 on diabetes care among people who are LGBTIQA+ 🏳️‍🌈🏳️‍⚧️

Great to see this on the program, especially during Pride Month.

(pinging @edjpedjp and @KaiSchweizer as you might want to follow the ADA hashtag for this session!)

First is Dr Nicole VanKim (umass.edu/sphhs/person/n…) speaking on social determinants of health.

Lesbian and bisexual women had a higher risk of T2D than straight women. This varied by age: 144% higher in those aged under 39

#ADA2022

Dr VanKim:

Prevalence of poverty is also higher in the LGBT community.

This statistic comes from the "LGBT poverty in the United States" report by Badgett et al: escholarship.org/content/qt37b6…

#ADA2022

Dr VanKim: a lot of the research in this space focuses on sexual orientation, there's less research among trans and gender diverse populations #ADA2022

Dr Jamie Feldman: barriers in diabetes care for people who are transgender or gender diverse.

Important to consider minority stress. Trans people experience stressors at a higher rate than straight people, and also more than other groups in the LGBTQIA+ community

#ADA2022

Dr Jamie Feldman: the trans and gender diverse population also tend to be more racially diverse and sexuality diverse. This means that they may also be more likely to experience racial minority stress

#ADA2022

Dr Jamie Feldman: unfortunately this population also experience frequent discrimination from health care providers. There needs to be more education for health care professionals.

#ADA2022

Dr Jamie Feldman: the trans and gender diverse population are also more likely to not have health insurance. Multiple studies have shown they experience a delay in care due to cost #ADA2022

Dr Jamie Feldman: the healthcare system is systematically not gender affirming for trans and gender diverse people. In healthcare, it's designed that legal sex = sex assigned at birth = gender. there's a lack of awareness. This is a barrier to good care.

#ADA2022

Dr Jamie Feldman: this is an issue with electronic medical records too. For example, incorrect pronouns, deadnames being on medical records. This leads healthcare professionals to misgender their patients.

#ADA2022

Dr Jamie Feldman: the concept of the "gender binary" is also an issue, especially when it comes to clinical guidelines and lab reference ranges e.g. creatinine

#ADA2022

Dr Jamie Feldman:

How do we reduce these barriers?

Affirm: e.g. using right pronouns, supporting gender affirming treatments
Address: e.g. refer to mental health care team, include the trans and gender diverse community
Advocate for systemic change at all levels.

#ADA2022

Next up is @cjstreed speaking on disparities in diabetes risk factors, disease prevention, and complications among LGBTQ populations #ADA2022

Dr Streed is sharing data from the Gallup 2021 survey on the percentage of those in the US who self identify as LGBT+

news.gallup.com/poll/389792/lg…

#ADA2022

Work from Beach et al (liebertpub.com/doi/full/10.10…)

Has shown that "Sexual minorities may be at increased risk for diabetes than their heterosexual peers. This may be due partly to the chronic stressors associated with being a member of a marginalized population" #ADA2022

Work from @cjstreed and others on cardiovascular health among trans and gender diverse populations: ahajournals.org/doi/full/10.11…

"People who are TGD experience significant stressors that affect cardiovascular health across the lifespan" #ADA2022

Final talk in this session from Dr Lauren Beach (@laurenbbeach)

It's on representation of LGBTQ individuals in diabetes research, and limitations of the current research and data. #ADA2022

In the national health and nutrition examination study, people over the age of 59 weren't asked any of the questions about sexual orientation. That means we're missing lots of data about the LGBT community in the 60+ age range. #ADA2022

Some good news: SOGI (sexual orientation and gender identity) data fields are becoming more common in electronic medical records. When it's available at scale, it's a very powerful tool to study diabetes in sexual and gender minority (SGM) populations #ADA2022

And some great news: pridestudy.org

"The PRIDE Study is the first large-scale, long-term national health study of people who identify as lesbian, gay, bisexual, transgender, queer (LGBTQ+), or another sexual or gender minority."

papers avail on their site

#ADA2022

@threadreaderapp unroll please 😊