Mortality among transgender persons: a Taiwan matched-population and sibling-comparison cohort study

作者：Chih‐Wei Hsu, Yang‐Chieh Brian Chen, Liang‐Jen Wang, Mu‐Hong Chen, Yao-Hsu Yang, Chih‐Sung Liang, Po-Yen Chen, Edward Chia‐Cheng Lai · 发表于：The Lancet Regional Health - Western Pacific · 年份：2025 · DOI：10.1016/j.lanwpc.2025.101715 · 被引用次数：1 · 研究领域：LGBTQ Health, Identity, and Policy、BRCA gene mutations in cancer、Genetic Associations and Epidemiology

Background: Transgender persons have been reported to experience excess mortality, but evidence is dominated by Western cohorts and seldom addresses familial confounding. Methods: We conducted a nationwide, retrospective cohort study using two prespecified comparison designs: matched population controls (1:4, matched on legal sex and birth date) and within-family cisgender sibling comparisons. Transgender persons were identified by ≥2 psychiatrist-recorded gender identity disorder diagnoses during 2001-2021; cohort entry required age ≥6 years. Participants were followed until death or December 31, 2022. We compared all-cause, external-cause (suicide and accidents), and internal-cause mortality using Cox regression adjusted for sociodemographics and medical comorbidity. Findings: Among 3906 transgender persons (mean age 24.6 years; 70.6% with a male legal sex) and 15,624 controls (mean follow-up 9.5 years), psychiatric conditions were markedly over-represented in the transgender cohort (e.g., depressive disorders 40.8% vs 5.7%). Adjusted hazard ratios were 1.40 (95% confidence interval 1.06-1.84) for all-cause mortality, 2.03 (1.39-2.96) for external causes, and 4.07 (2.52-6.59) for suicides; accidents (0.56, 0.21-1.45) and internal-cause (0.98, 0.65-1.48) mortality did not differ. In sibling comparisons (4765 siblings), excess all-cause and external-cause mortality were not observed (0.96, 0.67-1.36; and 1.14, 0.70-1.85), suicide risk was higher (2.57, 1.32-5.00), and acciden...