Solutions for Diagnostic Testing Issues for Transgender Patients
More Programs and Publications Featuring Dr. Brandy Gunsolus
In this program:
How can diagnostic testing issues for transgender patients be overcome? Medical laboratory scientist Dr. Brandy Gunsolus discusses where research on reference ranges stands and hopes for future solutions.
Transcript
Interviewer:
Regarding diagnostic testing, what are some other issues that the transgender community may face?
Dr. Brandy Gunsolus:
So one thing in diagnostic testing in particular that the transgender community faces, have to do with reference ranges or reference intervals. The reference ranges that we utilize, well, they were made on a heterosexual community. They were made on a cis-community that was not taking large amounts of sex hormones. We have learned through research with LGBTQIA community that taking these large amounts of sex hormones do impact various test intervals and those reference ranges. We know that. The problem is, we haven't been able to develop new ones yet. In order to develop a reference range, you need large numbers of individuals from that community. And, unfortunately, we have not been able to get large numbers of individuals from that community to develop these new reference ranges. So this is a issue really with not just representation within healthcare, but it's a patient safety issue.
And we, I will give you one example. We use eGFR as a calculation to put individuals on the kidney transplant list. That is one of several criteria. Well this calculation is different if you're female than if you were male. We have not been able to do the research because we don't have enough individuals to determine what is the right cut-off for transgender. So which one do you use for this community so that they can qualify for a kidney transplant? And right now we can't use either. And so this is an unfortunate limitation in access. It's a discrimination, but it's one that we currently haven't been able to complete the research to debunk I guess you could say, what the correct reference is for the transgender community so that they can get kidney transplants because transgender individuals they, if they need a kidney transplant it is no different than a cis individual needing a kidney transplant.
So there are issues especially when it comes to the diagnostic testing within this community, that we really need to do more research on. If you are a transgender individual that is on hormone therapy and you do see advertisements for being part of a study to develop reference intervals, I highly beg of you [laughter] please consider participating because it's only with large numbers are we going to be able to create these reference intervals in order to ensure that we're providing the best healthcare possible and we're not misdiagnosing transgender individuals because we don't have the right ranges.
Interviewer:
Can you share information on the study proposal that you've put together regarding transgender testing values?
Dr. Brandy Gunsolus:
So we are working on a proposal right now. We are working on the funding piece of it, but we are looking at going to a local pride next summer and setting up a booth this pride event typically gets 15,000 to 20,000 individuals. And we are hoping to collect, it will enroll patients into a reference interval study for the transgender population and collect as many transgender individuals as possible those that are on hormone therapy so that we can develop these reference ranges that are much needed in this community to prevent diagnostic error and ensure patient safety. If you see and I well, I am not the only one who is working on studies like this, there are some others that are also working on specific studies in, with various different types of laboratory testing. 'Cause there is much testing out there. So if you do happen to see a call for transgender people to be a part of a study to look and develop reference intervals or reference ranges for the transgender population, please consider participating If you are transgender or even non-binary, and on hormone replacement therapy.
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