ArticleHeadache2023
Headache prevalence in transgender and gender diverse youth: A single-center case-control study.
Article in Headache, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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The trial behind it
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.
- Sex-specific management of migraine a systematic review and consensus statement from the European Headache Federation (EHF).The journal of headache and pain · 2026Pooled it
- An Evolving Definition of Underserved Populations in Headache Medicine.Current pain and headache reports · 2026Review
- [Transgender health, migraine and headache-Underestimated associations, limited data situation].Schmerz (Berlin, Germany) · 2026Review
- Sex and gender-related differences in neurological diseases: current challenges and recommendations for clinical practice.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026Review
- Rapid review of gender-affirming healthcare for children and adolescents: Evidence synthesis (2021-2025) and recommendations for South Africa.Southern African journal of HIV medicine · 2026Review
- Rapid Review of Gender-Affirming Healthcare for Children and Adolescents: Evidence Synthesis (2021-2025) and Recommendations for South Africa.Research square · 2025Article
- Neurologic Care for Transgender and Gender-Diverse People: A Review of Current Evidence and Clinical Implications.Neurology. Clinical practice · 2024Review
- Evaluation and medical care of intersex and gender diverse youth.Pediatric radiology · 2024Review
Corrections and comments
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Authors and funding
2 authors at 2 institutions in 1 country.
Funding
Abstract
objectiveAssess the prevalence of headache in transgender and gender-diverse adolescents, comparing prevalence with and without exposure to gender-affirming hormone therapy.
backgroundTransgender and gender-diverse youth are an understudied group in whom we can study the effects of sex steroids on adolescents' development of headache. We hypothesized that transfeminine adolescents treated with estrogen would have higher odds of headache than those not treated, and that transmasculine adolescents treated with testosterone would have lower odds of headache than those not treated.
methodsThis retrospective case-control study analyzed all patients seen at the Boston Children's Hospital Gender Multispecialty Service clinic from 2007 to 2017. Cases were defined as patients with headache, controls as those without headache, and exposure as treatment with gender-affirming hormone therapy (i.e., estrogen or testosterone). A computerized search identified cases that were then validated by chart review.
resultsFifty-two of the 763 transgender and gender-diverse patients seen were confirmed to have headache. Of 273 transfeminine patients 45% (123/273) received estrogen treatment. Transfeminine patients receiving estrogen were more likely to have headache than those not receiving estrogen (7% [9/123] vs. 1% [2/150]; odd ratio [OR] 5.84 (95% confidence interval [CI] 1.24-27.6), p = 0.026). Of 490 transmasculine patients, 46% (227/490) received testosterone. Transmasculine patients receiving testosterone were more likely to have headache than those not receiving testosterone (12% [28/227] vs. 5% (13/263); OR 2.71 (95% CI 1.37-5.4), p = 0.005).
conclusionAmong transfeminine and transmasculine youth, those who received gender-affirming hormone therapy had higher odds of headache compared to those not taking gender-affirming hormone therapy. Further prospective studies to guide headache care of transgender and gender-diverse youth and adults are needed. Our results could be generalizable to other pediatric gender management clinics and may be worth discussing with patients considering treatment.
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Registered trials
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