Endo Battery Fast Charged: EP 7 LGBTQ+ Part 2

This episode of Endo Battery Fast Charged is a continuation into  research and its correlation between the LGBTQ+ Community and endometriosis.

Here are the articles that are highlighted in this episode:

Jones CE. Queering gendered disabilities. J Lesbian Stud. 2021;25(3):195-211. https://pubmed.ncbi.nlm.nih.gov/32567533/

Dysmenorrhea and Endometriosis in Transgender Adolescents. J Pediatr Adolesc Gynecol. 2020 Oct;33(5):524-528. https://pubmed.ncbi.nlm.nih.gov/32535219/

Hematospermia in a Transgender Woman with Evidence for Endometrial Tissue in the Prostate. AACE Clin Case Rep. 2024 Jan 24;10(3):80-83. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11127599/

Endometriosis in transgender men: recognizing the missing pieces. Front Med (Lausanne). 2023 Aug 31;10:1266131. https://pubmed.ncbi.nlm.nih.gov/37720510/

Website endobattery.com

Chapters

• 0:01 Expanding Perspectives on Endometriosis
• 9:10 Redefining Endometriosis

Transcript

Speaker 1: 0:01

Welcome to Endobattery Fast Charged, a series dedicated to keeping you informed and empowered in the realm of endometriosis. Teaming up with board-certified patient advocates, we bring you the latest articles, research and insights to equip you with accurate information and a deeper understanding. Whether you're expanding your knowledge, staying updated or seeking clarity, you're in the right place. I'm your host, alana, and is EndoBattery Fast Charged charging and empowering your life with knowledge. Welcome back to EndoBattery Fast Charged. Fabulous listeners, this month is Pride Month and a perfect time to look at and highlight the challenges the LBGTQ plus community faces with endometriosis. If you missed our last episode, I highly recommend you check it out. You won't want to miss a thing. Today, we're continuing our journey into the fascinating world of endometriosis research, especially as it relates to the care and healthcare of those in the LGBTQ plus community. Not only are we shining a light on this community, but we're also diving into some intriguing research that could change how we define and treat endometriosis. Now, before we get carried away, let's remember that correlation does not equal causation. These studies are like fun cousins at a family gathering, not the serious parents. They're here to inspire and empower us to push for inclusive change, but don't go jumping into conclusions just yet. So grab your glitter and let's get into it. This first highlighted study brings a lot to the surface when it comes to endometriosis and research.

Speaker 1: 1:38

Professor Kara Jones from California State University's Department of Women's and Gender Studies is a leading voice in feminist disability research, particularly known for her work on cultural narratives surrounding endometriosis. In her acclaimed study Queering Gender Disabilities, published in the Journal of Lesbian Studies in 2021, jones tackles the stubborn myth that endometriosis is primarily a reproductive disease, a narrative that has persisted in medical literature for nearly a century. Jones points out that this outdated perspective not only overlooks the many cisgender men, transgender and gender non-confirming individuals who suffer from endometriosis, but also perpetuates harmful treatment approaches. The focus on reproduction has led to interventions with high failure rates, causing further suffering, especially among LGBTQ plus populations. It's a bit like trying to fix a car's engine when the problem is actually the tires You're bound to miss the mark and make things worse. In her study, jones argues for a more gender neutral approach to discussing and treating endometriosis. She emphasizes the need for inclusive language and practices that recognize the diverse experiences of all people affected by this condition. By moving away from the narrow, reproductive-focused narrative, we can develop better, more effective treatments that truly address the need of everyone with endometriosis. So next time someone mentions endometriosis, remember that it's not just a women's issue. Thanks to researchers like Professor Jones, we're starting to see the bigger picture and push for change that can make a real difference for everyone dealing with this painful disease. After all, good science and compassionate health. As we go through this next case report, I want to remind you that I am not a medical professional and I didn't take six additional years to learn how to pronounce these medical terms correctly. So bear with me as we continue to walk through this.

Speaker 1: 3:30

But in this next fascinating case study titled Hermetospermia in Transgender Women with Evidence of Endometrial Tissue in the Prostate, researchers described an unusual medical finding in a 35-year-old transgender woman being treated for hematospermia, a condition characterized by the presence of blood in the seminal ejaculate. During the investigation, benign prosthetic tissue containing a small focus of malarian and endometrial type tissue was discovered. This intriguing case has significant implications for our understanding of endometriosis, particularly regarding its origins and the mechanisms behind its development. The authors of this study, published in AACE Clinical Case Reports, asserts that this finding provides strong evidence against the wildly discussed theory that retrograde transport of menstrual tissue is a primary case of endometriosis in cisgender women. According to the retrograde menstruation theory, menstrual blood flows backwards through the fallopian tubes into the pelvic cavity, leading to the implantation and growth of endometrial tissue outside the uterus. However, the presence of endometrial-type tissue in the prostate of transgender women who has never menstruated challenges this notion. Instead, the researchers suggest that this case supports the induction theory of endometriosis.

Speaker 1: 4:51

The induction theory posets endometrial tissue can develop from undifferentiated cells located outside the uterus, influenced by various factors such as hormones or inflammation. In this particular case, the endometrial tissue in its prostate likely originated from such precursor cells, which were then induced to differentiate into endometrial-like tissue. This aligns with the idea that endometriosis can occur in individuals regardless of their menstruation history, pointing to a more complex intrinsic mechanism of disease development. This study not only highlights the complexities of endometriosis, but it also underscores the importance of considering diverse patient populations when studying disease mechanisms. The findings from this case report may encourage researchers and clinicians to reevaluate traditional understanding of endometriosis and explore alternative explanations that could lead to more effective treatments and management strategies as we continue to uncover multifaceted nature of this condition. The hope is that such insights will ultimately improve patient care and outcome across different populations.

Speaker 1: 6:00

The discovery of endometrial tissue in the prostate of transgender women being treated for hematospermia provides compelling evidence supporting the induction theory of endometriosis. This challenges the retrograde menstruation hypothesis and opens new avenues for understanding and addressing this complex condition. The study serves as a reminder of the importance of inclusive research and the need to broaden our perspectives on disease mechanisms. In an older, smaller study called Dysmenorrhea and Endometriosis in Transgender Adolescents, the authors discovered that 7 out of 35 transmasculine individuals in their study population had endometriosis. Their findings highlight a critical issue the evaluation of endometriosis is often underutilized in transmasculine individuals who experience dysmenorrhea. The team emphasized that while some symptoms of endometriosis can be alleviated with testosterone treatment, it remains critical to consider the disease in trans patients presenting with symptoms irrespectable of their testosterone use.

Speaker 1: 7:01

The study underscores the need for heightened awareness and proactive evaluation of endometriosis in transgender adolescents. It seems that endometriosis doesn't discriminate based on gender identity, and the chronic pain it inflicts deserves attention and care. Gender adolescents it seems that endometriosis doesn't discriminate based on gender identity, and the chronic pain it inflicts deserves attention and care. So here's the takeaway Whether you're dealing with teens or adults, the message is clear Don't overlook endometriosis in transmasculine patients. It's easy to assume that testosterone will wave a magic wand and make all the symptoms disappear, but reality begs to differ. If someone's reporting pain, it's time to dig deeper, regardless of their hormone therapy status.

Speaker 1: 7:36

The study emphasizes the need to converge on a compassionate call to action. Transmasculine individuals deserve comprehensive healthcare that doesn't brush off their pain. By staying vigilant and considering endometriosis in patients with dysmenorrhea, we can offer them the care they need and deserve. Plus, who wouldn't want to be known for practicing medicine with both heart and knowledge on inclusive care? In this last study, it highlights that endometriosis is often thought of as a condition that affects only cisgender women, but this view is increasingly being challenged. The research article titled Endometriosis in Transgender Men Recognizing the Missing Pieces highlights that endometriosis is a significant issue for transgender men as well. Unfortunately, awareness about endometriosis in transgender men is still lacking, which can delay diagnosis and treatment, exacerbating the problem.

Speaker 1: 8:28

This 2023 overview emphasized the broader disparities in endometriosis care. They pointed out that people of color, transgender and non-binary individuals, those from socioeconomical disadvantaged backgrounds and adolescents face significant hurdles in getting diagnosed and treated. The gap in awareness among healthcare providers and policymakers is particularly troubling. If endometriosis goes undiagnosed or is inadequately treated, it can lead to severe consequences like chronic pain, infertility, depression and a drastically reduced quality of life. In essence, we need to shift our understanding of endometriosis from a niche women's health issue to a broader, more inclusive healthcare concern.

Speaker 1: 9:10

As precision medicine advances, recognizing and addressing the unique needs of individuals affected by endometriosis is crucial. This means better education for healthcare providers, more inclusive research and policies that ensure equitable access to care for everyone, regardless of their gender identity, race or socioeconomic status. In conclusion, it's time to update our perspective on endometriosis. It's not just a women's disease. It's a human disease that can impact anyone. By broadening our understanding and improving our approach to diagnosis and treatment, we can significantly enhance the quality of life for all those affected. Thank you for joining me this week, and I encourage you to continue looking into the disparities in which many face when it comes to endometriosis diagnosis and care, because if we understand it, then we can advocate better and we can continue advocating for the change that needs to take place to accelerate diagnosis, care and treatment. Until next time, continue advocating for you and for those that you love.