A lack of research makes it difficult to estimate how exactly migraine affects transgender populations. Some studies suggest that headaches and migraine may be more common among transgender people and people who take gender affirming hormone therapy (GAHT).
Some contributing factors may include hormone therapy, surgery, stress, and lack of medical attention.
If you are transgender and experience headaches or migraine episodes, medications and other therapies can help you find relief. It’s possible that some factors related to your transgender identity or hormone therapy may be contributing to migraine, but other factors — such as family history, headache triggers, and underlying health conditions — are more likely to influence your symptoms.
Very few studies have examined the prevalence of migraine in transgender populations, so it’s difficult to estimate how common it may be.
A 2021 research review notes that some studies have found comparable rates of migraine in transgender women compared with cisgender women, but other research suggests that there may be higher rates among transgender people.
The variation in results may be due to small numbers of study participants and a diversity in the population related to GAHT and surgeries.
Migraine rates in the general population and the hormonal connection
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People assigned female at birth often begin experiencing migraine episodes when they begin menstruation. For many people, migraine patterns are linked to the menstrual cycle.
This may affect the transgender population in a few ways. Transmasculine people who receive testosterone, estrogen suppression, or have their ovaries removed may experience significant fluctuations in estrogen that may affect migraine patterns.
Also, transfeminine people who receive estrogen may experience symptoms associated with estrogen exposure.
A small 2023 study involving transgender and gender diverse youth found that, compared to the individuals who did not receive hormone treatment, there were higher rates of headache in:
- transfeminine people receiving estrogen
- transmasculine people receiving testosterone
It’s important to note that this study didn’t focus solely on migraine, but headache in general. The researchers also note that starting GAHT in adolescence may produce different effects than starting GAHT in adulthood, since hormones like estrogen and testosterone play key roles in brain structure and function.
Studies included in a 2022 research review have arrived at conflicting results. Some studies show new-onset or worsening headache after starting GAHT, while others show an improvement in headache. Like other research, these studies didn’t focus solely on migraine.
Studies focused on specific populations that control for factors like the type of GAHT, the age when it was started, and changes in migraine before and after GHAT may help explain these conflicting results.
What about gender affirming surgery?
Surgeries that affect hormone production, like oophorectomies, may
Some migraine medications may interact with hormonal medications.
For example, topiramate (Topamax) is an antiseizure medication that doctors may prescribe for migraine. It
It’s important to remember that hormones aren’t the only important factor to consider. All the factors that influence migraine in the general population —
Transgender people are also more likely to experience stress and mental health conditions like anxiety and depression. These factors can contribute to migraine and lead to worse pain outcomes, so a comprehensive approach to mental health and migraine management may be particularly important for transgender people.
It’s also important to remember that headaches and migraine episodes may be symptoms of underlying medical conditions. Transgender people often have barriers to healthcare, which can prevent them from getting adequate treatment.
This lack of access to care may also prevent timely diagnosis and treatment of underlying medical conditions, such as cardiovascular disease, which may be more likely to develop in transgender individuals.
If you or someone you know is transgender and experiencing migraine, here are a few steps to consider.
Try searching for an LGBTQIA+-friendly doctor if you don’t already have one. Primary care doctors can often help manage migraine, but a specialist, like a neurologist, may also be necessary. If you also need mental health support, a therapist can be a great addition to your care team.
Be sure to tell them about any medications you take, including hormone therapy medications, and whether you’ve had any surgeries. They can help you find a migraine treatment that’s right for your specific situation.
Resources
- Check out this guide to finding healthcare professionals who are LGBTQIA+ allies, which lists associations, education centers, and directories that can help you find the right support.
- Learn more about finding an LGBTQIA+ affirming therapist.
- Explore tips for advocating for yourself at the doctor’s office.
- Dive deeper into gender affirming healthcare.
- Visit Healthline’s LGBTQIA+ Health resource center to learn more about healthcare, relationships, wellness, and support.
It’s not clear exactly how migraine affects transgender populations.
Larger, transgender-specific, and migraine-specific studies are needed to determine how common migraine may be, how hormone therapy may influence migraine, and how treatments may need to be tailored to the specific needs of transgender people.
Talk with your doctor about how you can manage migraine.