Zarif A. Ladak, BS
Second Year Medical Student
Rowan-Virtua SOM
Voorhees Township, New Jersey, United States
Anish Myneni, BS
Medical Student
Kansas City University
Johns Creek, Georgia, United States
Milan Patel, BS
Medical Student
Touro College of Osteopathic Medicine-Middletown
Newburgh, New York, United States
Tanya Juneja, MD
Resident
Johns Hopkins
Baltimore, Maryland, United States
R. Samuel S. Mayer, MD, MEHP
Professor, Dept of PM&R
Johns Hopkins U SOM
Baltimore, Maryland, United States
A twenty-year-old transgender woman presented to outpatient rehabilitation with a recent diagnosis of EDS in June 2023. The patient has been living in her affirmed gender since age fourteen and takes Spironolactone 50 MG tablet once daily, Estradiol 2 MG tablets twice daily, and Progesterone 100 MG tablets once daily. She reported severe pain in the bilateral knees and hips, a common complication of EDS, for which she is receiving physical therapy. On reevaluating Beigton’s criteria, the patient met six out of nine items reconfirming the EDS diagnosis.
Discussions:
Ensuring that the rehabilitation team is well-prepared to care for transgender individuals is essential for promoting access to care, participation in therapy, and health equity. It is unclear whether hormone therapy may play a role in exacerbating EDS symptoms, but clinicians need to be respectful of the life-saving nature of these treatments.
In the context of EDS, transgender patients may require specific rehabilitation strategies that account for both their condition and gender identity. Physical therapy should focus on strengthening muscles around the joints while avoiding stretching that exacerbates symptoms. Additionally, considering the potential psychological impacts of chronic pain and limited mobility, compounded by social stigma and discrimination, is imperative.
Physiatrists can address these disparities by providing culturally competent care and implementing inclusive policies. This includes training healthcare providers on LGBTQIA+ health issues and ensuring staff use patients' preferred pronouns and names.
Conclusions:
This case highlights the importance of collaboration between healthcare providers to manage the rehabilitation of transgender individuals with EDS. Emphasizing an inclusive approach and addressing barriers to care can significantly improve health outcomes and support the well-being of transgender patients undergoing rehabilitation.
