Sexual and gender minority (SGM) individuals are at risk for various neurological deficiencies, including autism spectrum disorder and ischemic stroke. However, more research is needed, according to a review published in JAMA Neurology.
Data on the neurological health needs of SGM individuals, including those who are lesbian, gay, bisexual, transgender and identify with the queer spectrum, is scarce. The aim of the current scoping review was to present the available data on SGM health in neurology and to identify areas with knowledge gaps.
After a systematic search for articles published in PubMed, Embase, Web of Science, PsycINFO, CINAHL and BIOSIS Previews, a total of 348 studies were reviewed, including 205 (58.9%) case reports or series.
Most of the studies focused on gay or bisexual cisgender men (252 articles, 72.4%) or HIV (247 articles, 71.0%). Neuroinfectious diseases were the most widely studied topic (200 articles, 57.5%), followed by cognitive neurology (60 articles, 17.2%), cerebrovascular diseases (16 articles, 4.6%), and autism (16 articles, 4 , 6%). The literature on neuroinfectious diseases in SGM patients has mainly focused on HIV (173 articles; 86.5%).
Of the 16 studies investigating the possible association between gender dysphoria and autism spectrum disorder, 9 studies (56.3%) reported a positive correlation.
Several studies suggested an increased risk of ischemic stroke in transgender women, but there was no evidence of this increased risk in transgender men and gender-specific individuals compared to cisgender people. In addition, a very short sleep duration was associated with an increased risk of reporting strokes in SGM subjects (adjusted odds ratio, 4.1; 95% CI, 2.2-7.6).
Studies examining sleep in SGM subjects reported conflicting results. In addition, the literature on headache in SGM patients was sparse. Conclusions on other neurological topics, including multiple sclerosis, epilepsy, or movement or neuromuscular disorders, were limited due to a lack of data.
A major limitation of the neurological literature examined was the lack of data on sociodemographic factors that affect health, including race, ethnicity, socioeconomic status, and immigrant or refugee status, which limited the generalizability of the results to the SGM community.
“Expanding neurological research to include a broader representation of SGM identities and the inclusion of sociodemographic factors such as race / ethnicity and socioeconomic status is essential. Capturing sexual orientation and gender identity in electronic health records, patient registers, and all public health surveys would be an important step in promoting equitable neurological care for this underserved community, ”said the study’s researchers.
Rosendale N, Wong JO, Flatt JD, Whitaker E. Health of Sexual and Gender Minorities in Neurology: An Overview of the Scope. JAMA Neurol. Published online February 22, 2021. doi: 10.1001 / jamaneurol.2020.5536