Grant: Op. Gr. Adv. 2S_LGBTQI+ Heal. Thr. Res. - Advancing 2S/LGBTQI+ Health

Transgender and non-binary people who start gender-affirming hormone therapy often report meaningful benefits to well-being and daily life. However, there is limited long-term research on how hormone therapy may affect kidney function and cardiovascular health over time, and how these health changes relate to participation in everyday activities such as school, work, and community life. This knowledge gap makes it harder for individuals, families, and health-care providers to make fully informed decisions and to plan appropriate monitoring and support. This study will follow transgender and non-binary participants from before they start gender-affirming hormone therapy and for four years afterward. Participants will complete assessments at baseline (prior to therapy) and then once per year. We will measure kidney function using a highly accurate test that involves a small injection of iohexol to directly measure glomerular filtration rate (GFR). We will also assess blood pressure and markers of vascular health to better understand cardiovascular risk. In addition, participants will complete questionnaires about quality of life and measures of "life participation," including involvement in school, employment, social relationships, and community activities. This project is grounded in partnership. The research team includes community partners and people with lived experience, alongside experts in nephrology, cardiovascular health, social sciences and business. The study addresses a need identified by the transgender and non-binary community and is designed to produce practical evidence that can improve clinical care, inform monitoring guidelines, and support overall health and life participation for transgender and non-binary people receiving gender-affirming hormone therapy.