Effects of Race and Gender Classifications on Atherosclerotic Cardiovascular Disease Risk Estimates for Clinical Decision-Making in a Cohort of Black Transgender Women
Introduction: Despite their dynamic, socially constructed, and imprecise nature, both race and gender are included in common risk calculators used for clinical decision-making about statin therapy for atherosclerotic cardiovascular disease (ASCVD) prevention. Methods and Materials: We assessed the effect of manipulating six different race-gender categories on ASCVD risk scores among 90 Black transgender women. Results: Risk scores varied by operationalization of race and gender and affected the proportion for whom statins were recommended. Discussion: Race and gender are social constructs underpinning racialized and gendered health inequities. Their rote use in ASCVD risk calculators may reinforce and perpetuate existing inequities.
Authors
- Asa E. Radix (ORCID: https://orcid.org/0000-0001-9611-4181)
- William La Cava (ORCID: https://orcid.org/0000-0002-1332-2960)
- Jowanna Malone (ORCID: https://orcid.org/0000-0002-2846-0012)
- Catherine R. Lesko (ORCID: https://orcid.org/0000-0002-1717-2592)
- Kenneth Hugh Mayer (ORCID: https://orcid.org/0000-0001-7460-733X)
- Ashleigh J. Rich (ORCID: https://orcid.org/0000-0003-3742-7086)
- Elle Lett (ORCID: https://orcid.org/0000-0002-6590-7821)
- Carl G. Streed (ORCID: https://orcid.org/0000-0003-3075-253X)
- Tonia Poteat (ORCID: https://orcid.org/0000-0001-6541-3787)
- Huijun Jiang (ORCID: https://orcid.org/0000-0002-7918-8805)
- Sari L. Reisner (ORCID: https://orcid.org/0000-0001-7868-4746)
- Alexander B. Harris (ORCID: https://orcid.org/0000-0002-9991-1482)
- Andrea L. Wirtz (ORCID: https://orcid.org/0000-0002-2063-1534)
Institutions
- University of North Carolina at Chapel Hill (US)
Publication Details
- Journal
- UNC Libraries
- Published
- 2025-03-21
- DOI
- https://doi.org/10.17615/nse5-6a84
- Primary Topic
- Sex and Gender in Healthcare
- Type
- article
- Field-Weighted Citation Impact
- 0.00
Funders
- American Heart Association
- School of Medicine, Boston University
- ViiV Healthcare
- National Heart, Lung, and Blood Institute
- National Institute of Child Health and Human Development
- National Institute on Minority Health and Health Disparities
- Eunice Kennedy Shriver National Institute of Child Health and Human Development