Policy and Statistical Barriers Impeding Organ Transplant for Transgender, Gender Diverse and Nonbinary Patients

Our goal is to highlight the specific structural barriers, inequitable policies and challenges faced by transgender, gender diverse and nonbinary (TGD) patients in access to kidney transplantation. We aim to identify opportunities where evidence can be applied to improve access and overcome enduring health inequities for transplant patients within the TGD community.

Kidney function estimations with common equations may be imprecise in TGD patients. Gender affirming hormone therapy (GAHT) impacts kidney function parameters, modulates risk for kidney transplant peri-operatively and provision of post-transplant care. Evidence based approaches to infection risk evaluation in donors would substantially expand the donor pool for organs and tissues.

Many opportunities exist to improve equity in access to kidney transplantation and donation for TGD patients. Further research is needed to better understand how to manage risk and meet needs for both gender affirming care and transplantation.