Neurologic Care for Transgender and Gender-Diverse People: A Review of Current Evidence and Clinical Implications.

PURPOSE OF REVIEW: To summarize the literature on neurologic care for transgender and gender-diverse (TGD) people and provide implications for clinical practice.

RECENT FINDINGS: There are limited data on the frequency and management of neurologic conditions among TGD people. TGD people have a higher prevalence of various neurologic conditions compared with cisgender or general population cohorts, including migraine, subjective cognitive decline, sleep disturbances, functional disorders, and cerebrovascular disease. Gender-affirming hormone therapy interacts with commonly prescribed neurologic medications and increases stroke risk among transfeminine people. Sex hormones and sex chromosomes may play a role in neurodegeneration and disability progression in neuroimmunologic diseases. Clitoral reduction surgeries on intersex children can cause neurologic disability and sexual dysfunction in adulthood. Socioeconomic disparities among TGD people contribute to health care barriers.

SUMMARY: Neurologists should consider the unique experiences and health care needs of TGD people in their clinical practice and research protocols.