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UTI rates appear higher in transgender women vs cisgender women


In this video, David Gilbert discusses the background and notable findings from the recent Urology paper, “Rates of UTI in Transgender Women Post-Vaginoplasty versus Cisgender Women: A Retrospective Cohort Study in a Large US Health Network.” Gilbert is an MD candidate at Case Western Reserve University School of Medicine in Cleveland, Ohio.


Please describe the background for this study.

We're part of a...group for LGBTQ medical research, so we do a lot of research for the trans population. There have been a lot of competing studies on urinary tract infection rates in trans women after a vaginoplasty, with some saying they have 0% outcomes with UTIs or up to 32%. Some studies have said they are less than what you would experience for a cisgender woman, or more. We have access to a very large database called TriNetX. We wanted to utilize that to get a more definitive look at what that rate might be.

What were some of the notable findings? Were any of them surprising to you and your coauthors?

Three main findings came out. Our hypothesis was that the rate of UTIs in trans women was going to be greater than in cis women. But we found that it was actually up to 16% higher in transgender women for some of the cohorts. The 3 main findings were that trans women, when age matched against cisgender women, always had a higher rate of UTIs, no matter the time since surgery. This difference grew with time. So the longer they got out from the vaginoplasty, the greater the difference between UTI rates between trans women and cis women. And then the other interesting finding we had is that there's a pretty well documented bimodal distribution of UTIs in cisgender women where it peaks in early adulthood, when they're more sexually active, and then later adulthood, like in the elderly, but it dips in middle age. But for trans women, we found that the rate kept going up with age without that bimodal distribution, which made us think that there probably are biological or behavioral factors that influence the rate differently than for cisgender women.

This transcription was edited for clarity.

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