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Article
Characteristics of Transgender Patient Cases Managed by a Toxicologist: an Analysis of the Toxicology Investigator's Consortium (ToxIC) Registry: January 2017-June 2019.
J Med Toxicol
  • Ryan M Surmaitis, DO, Lehigh Valley Health Network
  • Marna R Greenberg, DO, MPH, FACEP, Lehigh Valley Health Network
  • Natalie E Ebeling-Koning, DO, Lehigh Valley Health Network
  • Phillip M Grenz, DO, Lehigh Valley Health Network
  • Cody R McWhirter, BS, Lehigh Valley Health Network
  • Beth Careyva, M.D., Lehigh Valley Health Network
  • Judith Sabino, MPH, CDP, Lehigh Valley Health Network
  • Matthew D Cook, DO, Lehigh Valley Health Network
  • Robert D. Cannon, DO, Lehigh Valley Health Network
  • Andrew L Koons, Lehigh Valley Health Network
  • Kenneth D Katz, MD, Lehigh Valley Health Network
  • Hope Kincaid, MPH, CPH, Lehigh Valley Health Network
  • Lexis Laubach, BS, Lehigh Valley Health Network
  • Gillian A. Beauchamp, MD, Lehigh Valley Health Network
Publication/Presentation Date
6-17-2020
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.

PubMedID
32557176
Peer Reviewed for front end display
Peer-Reviewed
Document Type
Article
Citation Information

Surmaitis, R. M., Greenberg, M. R., Ebeling-Koning, N. E., Grenz, P. M., McWhirter, C. R., Careyva, B. A., Sabino, J. N., Cook, M. D., Cannon, R. D., Koons, A. L., Katz, K. D., Kincaid, H., Laubach, L. T., Beauchamp, G. A., & toxicology investigator’s consortium (ToxIC) (2020). Characteristics of Transgender Patient Cases Managed by a Toxicologist: an Analysis of the Toxicology Investigator's Consortium (ToxIC) Registry: January 2017-June 2019. Journal of medical toxicology : official journal of the American College of Medical Toxicology, 10.1007/s13181-020-00789-1. Advance online publication. https://doi.org/10.1007/s13181-020-00789-1