Abstract 9603: An Examination of Differences in Ideal Cardiovascular Health Between Gender Minority and Cisgender Adults in the Behavioral Risk Factor Surveillance System

Introduction: Gender minority (e.g., transgender, gender nonbinary) adults have been shown to be at higher risk of cardiovascular disease (CVD) compared to cisgender adults. However, prior research has primarily examined differences in individual cardiovascular health (CVH) metrics rather than composite measures. We examined gender identity differences in ideal CVH using the American Heart Association’s Life’s Simple 7, which includes three health behaviors (i.e., tobacco use, diet, and physical activity) and four health factors (i.e., body mass index, hypertension, diabetes, and total cholesterol). Methods: We analyzed self-reported data from the Behavioral Risk Factor Surveillance System (2015-2019). Participants received a score of 0 (nonideal) or 1 (ideal) for each CVH metric and scores were summed to calculate ideal CVH scores (continuous; range 0-7). We ran regression models, adjusted for demographic and clinical factors, to compare ideal CVH scores and the odds of meeting criteria for ideal CVH (i.e., ≥5 CVH metrics with score of 1) between gender minority and cisgender adults. We separately compared all groups of gender minority participants (i.e., transgender women, transgender men, gender nonbinary) to both cisgender women and men. Results: The sample included 368,541 participants, of which 99.6% were cisgender, 0.3% were transgender, and 0.1% were nonbinary. Transgender women ( B = -0.22, p <0.01) and gender nonbinary ( B = -0.42, p <0.01) participants had lower ideal CVH scores than cisgender women. No differences in ideal CVH scores were found when comparing gender minority adults to cisgender men. Transgender women (AOR 0.54, 95% CI = 0.50, 0.76) and gender nonbinary (AOR 0.46, 95% CI=0.30, 0.71) adults were less likely to meet criteria for ideal CVH than cisgender women. In contrast, transgender men were more likely to meet criteria for ideal CVH than cisgender men (AOR 1.61, 95% CI = 1.10, 2.36). Conclusions: Findings indicate that transgender women and gender nonbinary participants are at higher risk of CVD than cisgender women. Transgender men had a lower risk of CVD than cisgender men. Future research is needed to examine factors that may contribute to the CVH disparities observed among transgender women and gender nonbinary adults.