This original research describes a large cross-sectional study of gender identity minorities and quantifies the prevalence of migraine across this population’s identities.

Despite improvements in the education of clinicians regarding LGBTQIA+ health, there are currently no large epidemiological studies available in published literature examining the prevalence of migraine in gender identity minorities, which includes people who identify as transgender, gender non-binary, genderqueer, or questioning. A recent scoping review identified only a sparse number of case reports and small cross-sectional studies regarding headache presentations in this population. Given headache disorders are the second leading cause of years lived with disability worldwide as well as the known health disparities faced by gender identity minorities, migraine is a pressing example within neurology emphasizing the need for increased research within this population to deliver evidence-based care.

8783 subjects were identified from the electronic health record (EHR) of a multi-site academic healthcare institution based on EHR-documented gender identity, key word searches, and ICD 9 and 10 coding. A random selection of 496 subjects were reviewed in order to confirm gender identity. 328 subjects were validated and included in this study. Subjects were queried for sex assigned at birth, affirmed gender identity, age, use of gender-affirming hormones (GAH), and migraine diagnosis.

In the transwoman group (n=135), 85% were taking estrogenic GAH, and migraine prevalence was 19%. In the transman group (n=135), 84% were taking androgenic GAH, and migraine prevalence was 20%.