Background/Purpose: Fibromyalgia Syndrome (FMS), characterized by widespread pain and fatigue, is known to be more prevalent in women, and has frequently been associated with stress is various models. In the current study we have evaluated the prevalence of fibromyalgia symptoms among Transgender men and women, in attempt to correlate such symptoms with gender dysphoria and gender transformation due to hormonal therapy.

Methods: Participants were recruited among patients followed at a specialized transgender clinic at the endocrinology institute of a large tertiary medical center. Participants were at various stages of the process of gender reassignment, including hormonal treatment.

After providing informed consent, participants were asked to answer the Widespread Pain Index (WPI) and the Symptom Severity Scale (SSS), in order to document the presence of symptoms related to the fibromyalgia spectrum and in order to determine the prevalence of fibromyalgia, according to the 2010-2011 diagnostic criteria.

Results: Thirty-six transgender men [Female-to-male (FTM)] and 29 transgender women [Male-to-female (MTF)] answered the questionnaires. Eight individuals form the FTM group met fibromyalgia criteria (22.2%). Only 1 individual from the MTF group met the criteria for fibromyalgia (3.4%). Among FTM individuals, 13 were evaluated both before and after initiating androgen-based hormonal treatment, in order to evaluate the effect of such treatment on symptoms.

Out of 4 individuals fulfilling fibromyalgia criteria before receiving hormonal therapy, 3 remained unchanged when re-evaluated on treatment, while 1 reported alleviation of symptoms. One individual developed fibromyalgia symptoms after 1 year of hormone treatment. 

Conclusion: In this preliminary study, Fibromyalgia symptoms were found to be highly prevalent among Transgender men (FTM), at a rate significantly higher than reported in the general population. Fibromyalgia symptoms appeared to be less frequent among Transgender women (MTF).

These results are relevant for professionals treating transgender individuals in the medical or psychological field.  Further research into the effects of gender and of hormone treatment on fibromyalgia and chronic pain are indicated.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/evaluating-fibromyalgia-symptoms-in-transgender-patients/