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.
Competing Interests: T.P. and A.L.W. receive research funding from ViiV Healthcare to their research institutes unrelated to this work. C.G.S. receives consulting fees from EverlyWell, L'Oreal, and the Texas Health Institute unrelated to this work.
(© Tonia Poteat et al., 2023; Published by Mary Ann Liebert, Inc.)