Headache in transgender men using gender-affirming hormone therapy: A case-control study

Area of Science:

• Neurology
• Gender Studies
• Public Health

Background:

• Primary headache research often overlooks gender, focusing primarily on sex.
• Gender is a complex social construct influenced by cultural and environmental factors.
• Understanding headache prevalence across different gender identities is crucial for comprehensive healthcare.

Purpose of the Study:

• To compare the frequency, characteristics, and impact of primary headaches in transgender men (TM), cisgender men (CM), and cisgender women (CW).
• To investigate the influence of gender identity on headache disorders beyond biological sex.
• To provide data for more inclusive headache management strategies.

Main Methods:

• A case-control study involving 50 transgender men (TM), 50 cisgender men (CM), and 50 cisgender women (CW) aged-matched.
• Data collected using semi-structured questionnaires, the Headache Impact Test (HIT-6), and the Hospital Anxiety and Depression Scale.
• Analysis included conditional logistic regression, adjusting for relevant demographic and psychological factors.

Main Results:

• Transgender men (TM) exhibited significantly lower overall headache and tension-type headache (TTH) rates compared to cisgender men (CM).
• TM showed a significantly higher prevalence of migraine, particularly migraine without aura, compared to CM.
• No significant differences were found in headache type, frequency, or severity between TM and cisgender women (CW).

Conclusions:

• Headache patterns differ between transgender men and cisgender men, with TM experiencing less frequent headaches but more migraines.
• No significant differences in headache characteristics or severity were observed between transgender men and cisgender women.
• These findings highlight the importance of considering gender identity in headache research and clinical practice.