Transgender Adults From Minoritized Ethnoracial Groups in the US Report Greater Subjective Cognitive Decline

Objectives: Investigate subjective cognitive decline (SCD) among 4 study groups consisting of cisgender and transgender adults who are from minoritized ethnoracial groups (i.e., minoritized ethnoracial transgender, minoritized ethnoracial cisgender) and White cisgender and transgender adults aged 45+ (i.e., White transgender, White cisgender) to determine the odds of SCD by group and to test for group differences. Methods: Data from the 2015-2020 Behavioral Risk Factor Surveillance System were used in a modified case-control approach to perform an intercategorical intersectional study. Each transgender participant was matched to 2 cisgender men and 2 cisgender women, on state, ethnoracial identity, and age. Multivariable logistic regressions modeled SCD odds by group and post hoc contrasts estimated pairwise odds ratios comparing the SCD odds for each combination of groups. Results: SCD prevalence was highest among minoritized ethnoracial transgender (21.6%), followed by White transgender (15.0%), minoritized ethnoracial cisgender (12.0%), and White cisgender (9.0%). After accounting for age, education, and survey year, the odds of SCD were higher in minoritized ethnoracial transgender when compared to White cisgender (adjusted odds ratio [aOR] = 2.51, 95% confidence interval [CI]: 1.59-3.96) and minoritized ethnoracial cisgender (aOR = 1.89, 95% CI: 1.16-3.09). The odds of SCD were higher in White transgender compared to White cisgender (aOR = 1.66, 95% CI: 1.20-2.30). Discussion: When sidering the intersection of transgender and ethnoracial identities, we found that transgender adults from minoritized ethnoracial groups reported higher odds of SCD when compared to cisgender adults from minoritized ethnoracial groups. Additional studies are needed to understand the relationship between racialized and gendered inequities in cognitive impairment and how specific mechanisms of systemic transphobia and racism may contribute to this inequity.

Automated summary

The study investigated subjective cognitive decline (SCD) among different groups, including minoritized ethnoracial transgender individuals, minoritized ethnoracial cisgender individuals, White transgender individuals, and White cisgender individuals aged 45+. The results showed that the prevalence of SCD was highest among minoritized ethnoracial transgender individuals, followed by White transgender individuals, minoritized ethnoracial cisgender individuals, and White cisgender individuals. The odds of SCD were higher in minoritized ethnoracial transgender individuals compared to White cisgender and minoritized ethnoracial cisgender individuals, and higher in White transgender individuals compared to White cisgender individuals.