The journal Neurology has also published the latest findings from The PRIDE Study. This study is important because it is the first to look specifically at LGBTQ+ people’s experiences with headaches and the connections with trauma. This study illustrates how common headaches and migraines are for LGBTQ+ people.

What Did We Learn?

A total of 3,325 participants took the survey; 2,142 (64%) reported experiencing headaches and 1,126 (34%) reported experiencing migraines. On average, most people with migraines reported the strength was moderate or severe and frequent or strong enough to experience migraine-related disability, meaning the migraines affected their ability to participate in work, school, or home life. If they had a history of trauma and discrimination, they also were more likely to have migraines frequent or strong enough to experience migraine-related disability. However, for participants who had a history of depression, anxiety, or post-traumatic stress disorder, those who also had a history of trauma and discrimination were not more likely to experience migraine-related disability compared to those without a history of trauma and discrimination. This suggests that mental health conditions play an important role in experiencing migraine-related disability. Most of the people with migraines had access to a clinic or doctor’s office for healthcare (88%). About 42% of people with migraines wanted to see a specialist. However, 37% of this group had difficulty seeing a specialist, with the most common reason being that their insurance did not approve it. Additional reasons include their primary care doctor did not place the referral, the specialist was not accepting new patients, there were no specialists in their town or city, or the specialist refused to see them.

What Does This Mean for Our Communities?

This study showed that headaches and migraines are common for LGBTQ+ people, similar to the general public. We learned that many LGBTQ+ people with migraines do not have access to a specialist to help provide treatment. This can mean that headaches are not treated as well as they could be, which is important for primary care doctors to be aware of. LGBTQ+ people should also consider how their experiences with trauma, discrimination, and/or mental health conditions may have a connection with their experiences with migraines.

What’s Next?

Further education is needed for healthcare providers and specialists about the experiences of LGBTQ+ people with headaches. Studies about migraines or their treatment should collect information about sexual orientation and gender identity from participants to further understand how LGBTQ+ people are affected. Further research is needed to look at the barriers that LGBTQ+ people face when it comes to accessing healthcare, including looking at other aspects of their identity, such as race, ethnicity, or income level. The connection between depression, anxiety, and post-traumatic stress disorder with migraines should also be looked at further, as treatments for these mental health conditions may also help reduce the effects of migraines.

Further Reading

Rosendale N, Guterman EL, Obedin-Maliver J, Flentje A, Capriotti MR, Lubensky ME, Lunn MR. Migraine, migraine disability, trauma, and discrimination in sexual and gender minority individuals. Neurology Jul 2022, 10.1212/WNL.0000000000200941. https://doi.org/10.1212/WNL.0000000000200941.

We combined data from The PRIDE Study’s 2018 Annual Questionnaire and state healthcare policy protections from the Movement Advancement Project to understand whether state policies are related to decisions to avoiding healthcare among transgender and non-binary people.

This is the first study to look at the role of healthcare anti-discrimination policies in a state and whether the presence of those policies is related to the choice to avoid seeking healthcare among transgender and non-binary people.

What Did We Learn?

We found that experiencing poor treatment in healthcare related to one’s gender identity or expression was related to avoiding healthcare services in the past year. We found that the presence of state healthcare anti-discrimination policies did not change the relationship between poor treatment in healthcare and someone avoiding healthcare services in the past year.

What Does This Mean for Our Communities?

Transgender and non-binary people who live in states with healthcare anti-discrimination policies still avoid seeking healthcare. This is concerning because it increases the risk of poor health because illnesses may go untreated and health concerns may go un-diagnosed.

What’s Next?

We need to look at how healthcare anti-discrimination policies are put in place and how individuals and healthcare organizations are held accountable when poor experiences are reported. There is also an opportunity to look at ways to communicate with transgender and non-binary communities about what the policies in their state are and what their options are when poor treatment happens. We also need to look at how healthcare decisions are made by sub-communities within trans communities, such as trans people of color and trans people who may be undocumented.

Further Reading

Clark, K.D., Luong, S., Lunn, M.R., Flowers, E., Bahalkeh, E., Lubensky, M.E., et al. Healthcare Mistreatment, State-Level Policy Protections, and Healthcare Avoidance Among Gender Minority People. Sex Res Social Policy. 2022. Epub 2022, July 15. doi:10.1007/s13178-022-00748-1

Muscle dysmorphia means that someone is worried about not being muscular enough. Gender-expansive people do not identify as being exclusively a man or exclusively a woman. We asked gender-expansive people in The PRIDE Study to fill out a widely used survey in health research about this issue.

This was the first study to use these survey questions with gender-expansive people.

What Did We Learn?

We found three categories of concerns that gender-expansive people have about muscles: 1) a desire to be bigger and more muscular, 2) a dissatisfaction with the way their body looks, and 3) problems with normal life functions (such as passing up social activities because of their workout schedule).

What Does This Mean for Our Communities?

This survey is appropriate for use with gender-expansive people to understand their concerns around muscles. These results can help providers and researchers understand the muscle-related problems that gender-expansive people are having and ask better questions to provide them with better care.

What’s Next?

We want to study concerns about muscles among transgender women.

Further Reading

Compte EJ, Cattle CJ, Lavender JM, Brown TA, Murray SB, Capriotti MR, Flentje A, Lubensky ME, Obedin-Maliver J, Lunn MR, Nagata JM. Psychometric evaluation of the Muscle Dysmorphic Disorder Inventory (MDDI) among gender-expansive people. J Eat Disord. 2022 July;10:95. doi: https://doi.org/10.1186/s40337-022-00618-6