Transgender Adults from Minoritized Ethnoracial Groups in the U.S. Report Greater Subjective Cognitive Decline.

OBJECTIVES: Investigate subjective cognitive decline (SCD) among four study groups consisting of cisgender and transgender adults who are from minoritized ethnoracial groups (i.e., minoritized ethnoracial transgender, minoritized ethnoracial cisgender) and White cisgender and transgender adults aged 45+ (i.e., White transgender, White cisgender) to determine the odds of SCD by group and to test for group differences.

METHODS: Data from the 2015-2020 Behavioral Risk Factor Surveillance System were used in a modified case-control approach to perform an intercategorical intersectional study. Each transgender participant was matched to two cisgender men and two cisgender women, on state, ethnoracial identity, and age. Multivariable logistic regressions modeled SCD odds by group and post-hoc contrasts estimated pairwise odds ratios comparing the SCD odds for each combination of groups.

RESULTS: SCD prevalence was highest among minoritized ethnoracial transgender (21.6%), followed by White transgender (15.0%), minoritized ethnoracial cisgender (12.0%), and White cisgender (9.0%). After accounting for age, education, and survey year, the odds of SCD were higher in minoritized ethnoracial transgender when compared to White cisgender (aOR=2.51, 95% CI:1.59-3.96) and minoritized ethnoracial cisgender (aOR=1.89, 95% CI:1.16-3.09). The odds of SCD were higher in White transgender compared to White cisgender (aOR=1.66, 95% CI:1.20-2.30).