Examining the association between gender affirming hormone therapy and seizures during inpatient hospitalization among transgender women in the United States.

PURPOSE: The purpose of this paper is to explore the association between the use of Gender-Affirming Hormone Therapy (GAHT) and seizures among transgender women.

METHODS

We used the 2016-2019 Healthcare Cost and Utilization Project's National Inpatient Sample to evaluate the prevalence of seizures among inpatient hospitalizations of transgender women who did and did not use GAHT. The sample was defined using the International Classification of Diseases, 10th Revision diagnostic codes. We performed multivariate regression and a 1:1 propensity-score matched analysis to identify predictors of seizure prevalence.

RESULTS

Of the 4765 transgender women included in the analysis, 254 (5.3%) used GAHT. Hospitalized transgender women who used GAHT were more likely to be younger (p < 0.001) and to have private insurance (p < 0.001) compared with hospitalized transgender women who did not use GAHT. Multivariable analysis revealed that transgender women who used GAHT had decreased odds of seizures during inpatient hospitalization versus transgender women who did not use GAHT; however, results were not statistically significant (Odds Ratio 0.65, 95% Confidence Interval 0.16-1.78, p = 0.47).

CONCLUSIONS

In this population-based examination of a large, national database, use of GAHT among transgender women was not associated with an increased risk of seizure during inpatient hospitalization. Our study's findings mark an important step towards demonstrating the safety of GAHT in regard to seizures. Future research would benefit from longitudinal assessments of seizure incidence and outcomes in non-hospitalized transgender people.