Ryan M Surmaitis1,2, Marna Rayl Greenberg3, Natalie E Ebeling-Koning1, Phillip M Grenz1, Cody R McWhirter1, Beth A Careyva4, Judith N Sabino5, Matthew D Cook1,2, Robert D Cannon1,2, Andrew L Koons1,2, Kenneth D Katz1,2, Hope Kincaid6, Lexis T Laubach1, Gillian A Beauchamp1,2. 1. Department of Emergency and Hospital Medicine, Lehigh Valley Health Network/USF Morsani College of Medicine, Cedar Crest Boulevard & I-78, 1909 Earls Court, Allentown, PA, 18103, USA. 2. Division of Medical Toxicology, Department of Emergency and Hospital Medicine, Lehigh Valley Health Network/USF Morsani College of Medicine, Cedar Crest Blvd & I-78, Allentown, PA, 18103, USA. 3. Department of Emergency and Hospital Medicine, Lehigh Valley Health Network/USF Morsani College of Medicine, Cedar Crest Boulevard & I-78, 1909 Earls Court, Allentown, PA, 18103, USA. mrgdo@ptd.net. 4. Department of Family Medicine, Lehigh Valley Health Network/USF Morsani College of Medicine, Cedar Crest Boulevard & I-78, Allentown, PA, 18103, USA. 5. Department of Medicine, Lehigh Valley Health Network/USF Morsani College of Medicine, Cedar Crest Boulevard & I-78, Allentown, PA, 18103, USA. 6. Network Office of Research and Innovation, Lehigh Valley Health Network/USF Morsani College of Medicine, Cedar Crest Blvd & I-78, Allentown, PA, 18103, USA.
Abstract
INTRODUCTION: The Toxicology Investigators Consortium (ToxIC) database, created in 2010 by the American College of Medical Toxicology (ACMT), compiles data recorded by medical toxicologists. In January 2017, the data field for transgender (and if transgender, male-to-female or female-to-male) was added to the ToxIC form. Little is known regarding trends in poisonings among transgender patients. We sought to review consultations managed by a bedside toxicologist and provide descriptive data in trends among types of exposures within the transgender demographic. METHODS: A retrospective ToxIC database evaluation of cases in which the patient identified as transgender were reviewed from January 2017-June 2019 and descriptive demographics reported. RESULTS: The registry contained 113 cases that involved transgender patients. Of those with complete data, 41 (36.6%) were male-to-female, 68 (60.7%) were female-to-male, and 3 (2.7%) identified as gender non-conforming. Of those with complete data, the most common reason for encounter was intentional use of a pharmaceutical drug (N = 97, 85.8%), of which 85 (87.6%) were classified as intentional pharmaceutical use intended for self-harm. Analgesics were the most common class of drugs used out of those reported (N = 24, 22%). Forty-six (90.2%) patients aged 13-18 with complete data were identified as encounters due to self-harm. Attempt at self-harm was the most common reason for intentional pharmaceutical encounter among the sample of transgender patients with complete data (N = 85, 87.6%); with female-to-male patients having an N = 53 (77.9%). CONCLUSION: Among transgender patients in the ToxIC registry, the most common primary reason for the encounter was intentional use of a pharmaceutical drug intended for self-harm. In this small cohort, there were some age and transition differences in prevalence. These findings may inform poisoning prevention practices as well as sex- and gender-based management of patients in this vulnerable population.
INTRODUCTION: The Toxicology Investigators Consortium (ToxIC) database, created in 2010 by the American College of Medical Toxicology (ACMT), compiles data recorded by medical toxicologists. In January 2017, the data field for transgender (and if transgender, male-to-female or female-to-male) was added to the ToxIC form. Little is known regarding trends in poisonings among transgender patients. We sought to review consultations managed by a bedside toxicologist and provide descriptive data in trends among types of exposures within the transgender demographic. METHODS: A retrospective ToxIC database evaluation of cases in which the patient identified as transgender were reviewed from January 2017-June 2019 and descriptive demographics reported. RESULTS: The registry contained 113 cases that involved transgender patients. Of those with complete data, 41 (36.6%) were male-to-female, 68 (60.7%) were female-to-male, and 3 (2.7%) identified as gender non-conforming. Of those with complete data, the most common reason for encounter was intentional use of a pharmaceutical drug (N = 97, 85.8%), of which 85 (87.6%) were classified as intentional pharmaceutical use intended for self-harm. Analgesics were the most common class of drugs used out of those reported (N = 24, 22%). Forty-six (90.2%) patients aged 13-18 with complete data were identified as encounters due to self-harm. Attempt at self-harm was the most common reason for intentional pharmaceutical encounter among the sample of transgender patients with complete data (N = 85, 87.6%); with female-to-male patients having an N = 53 (77.9%). CONCLUSION: Among transgender patients in the ToxIC registry, the most common primary reason for the encounter was intentional use of a pharmaceutical drug intended for self-harm. In this small cohort, there were some age and transition differences in prevalence. These findings may inform poisoning prevention practices as well as sex- and gender-based management of patients in this vulnerable population.
Entities:
Keywords:
Drug misuse and abuse; ToxIC; Toxicological exposure; Transgender
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