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The Health of Lesbian, Gay, Bisexual, and Transgender People: Building a Foundation for Better Understanding
Much of the research on cardiovascular disease in LGBT populations has focused on the increased risk of such disease among those infected with HIV and among transgender individuals taking masculinizing hormones. However, not enough research has been conducted to firmly establish these risks. One prospective observational study involving male (n = 17,816) and female (n = 5,652) participants from previously established cohorts in Europe, Australia, and the United States suggests that antiretroviral treatment may be associated with cardiovascular events, such as myocardial infarction (Friis-Moller et al., 2003). Gooren and colleagues (2008) analyzed the effects of hormone therapy on a number of known risk factors for cardiovascular disease among male-to-female and female-to-male transgender patients at a clinic in the Netherlands. They found that patients receiving hormone treatment experienced both positive and negative changes in relation to certain risk factors but were unable to conclude whether the treatment had a significant effect on the risk of cardiovascular disease. More recently, Elamin and colleagues (2010) conducted a meta-analysis to examine the cardiovascular effects of hormone treatment on transsexuals. While they did not find significant effects of hormones on cardiovascular events, the authors note that the quality of the evidence was very low, and in many cases the data were insufficient to permit drawing conclusions. Their meta-analysis does suggest that hormone therapy may increase serum triglycerides in transsexuals.
One study of 4,135 women aged 18–64 in Los Angeles County examined cardiovascular health among self-identified lesbian, bisexual, and heterosexual women. Results showed that lesbians were significantly more likely than heterosexuals to receive a diagnosis of heart disease. For bisexual women, the risk for heart disease, although less than that of lesbians, was also elevated relative to heterosexual women, even though bisexual women were the youngest group in the sample (Diamant and Wold, 2003).
Some research suggests that lesbians and bisexual women have a higher risk of obesity than heterosexual females. As discussed previously, Case and colleagues (2004) found that lesbians and bisexual women were more likely to be overweight or obese than heterosexual women (and lesbians were more likely to be overweight or obese than bisexual women). In the study conducted by Cochran and colleagues (2001), also discussed previously, a greater prevalence of obesity was found among lesbians/bisexual women than in national estimates for women generally. For purposes of the study, the authors grouped lesbians and bisexual women together. Boehmer and