Gender diversity and cholesterol in early adolescence: Findings from the Adolescent Brain Cognitive Development Study

Previous research has shown that gender minorities face health inequities, including mental and physical health disparities, but few studies have examined cardiovascular disparities, such as lipid profiles, in early adolescents. Monitoring cholesterol in adolescence is important, as early lipid levels can predict future cardiovascular risk. This study aimed to assess associations between multiple measures of gender diversity and cholesterol profiles among early adolescents.

Data from 1511 participants aged 10-14 years in the Adolescent Brain Cognitive Development Study (2018-2021) were analyzed. Gender diversity was measured using transgender identity, felt gender (how much one feels like a boy/girl), gender expression (how gender is communicated through appearance and mannerisms), and gender non-contentedness (desire to be a sex or gender different from sex assigned at birth). Cholesterol measures included total, high-density lipoprotein (HDL), and non-HDL cholesterol. Multivariable linear and modified Poisson regression models adjusted for sociodemographic factors were used to estimate associations.

Participants were 47.0% female, 37.9% racial and ethnic minority, and 1.9-19.1% were gender-diverse depending on the measure. Higher felt gender and gender non-contentedness scores were associated with lower HDL cholesterol. Gender non-contentedness was associated with higher non-HDL cholesterol.

Some measures of gender diversity were associated with less favorable lipid profiles, including reduced HDL cholesterol. These findings build on prior research examining cardiovascular health in gender-diverse populations and highlight the need to investigate mechanisms underlying these associations.