P1280 Gender identity and inflammatory bowel disease: estimates of prevalence across Europe
Authors: Colwill M , Pollok R , Poullis A 
Published: January 2025

Abstract

Background
Societal trends in recent decades have led to greater expression and awareness of gender identity however little is known about the unique healthcare needs of people who identify as transgender or gender non-conforming (TGNC) particularly with regards to the impact of also suffering from a chronic disease such as inflammatory bowel disease (IBD). The duality of identifying as TGNC and also suffering from IBD (TGNC-IBD) is poorly understood with questions remaining about impact of IBD on gender-affirming hormones and vice versa, the mental health challenges and the impact of perianal disease on gender affirming surgery. Whilst some work has attempted to investigate the unique healthcare needs of this group of individuals,(1) there is still a significant gap in our knowledge including basic demographic data from this population. We therefore aimed to calculate for the first time the size of this under-researched population across Europe.

Methods
The global burden of disease study gathers data from various sources including censuses, household surveys, health service use and disease registries and uses a Bayesian meta-regression to provide prevalence estimates on a country-by-country basis. We used this data to generate estimates of the number of people suffering from IBD in each European country with available data.(2) The IPSOS Pride 2023 uses data from interviews of between 500 and 1000 people in each participant country and adjusts this data to reflect the demographics of that country.(3) Data from these two sources were then cross-referenced to calculate estimated numbers of TGNC-IBD individuals in each country. Any European country that did not have IPSOS data available was excluded.

Results
11 European countries were included in the IPSOS report. The results of the prevalence estimates are summarised in table 1. Germany had the highest number of overall IBD cases whilst Switzerland has the highest percentage of people identifying as TGNC. The greatest number of TGNC-IBD individuals was found in Germany at 7081.

Conclusion
Our analysis provides for the first time an estimate of prevalence of the TGNC-IBD population across multiple European countries and builds on previous work performed in the United Kingdom using national census data. We have demonstrated significant population sizes across Europe reinforcing the need for both greater awareness of, and greater research into, the unique needs of this under-represented minority.

References
1.Colwill M, Pollok R, Seal L, Poullis A. Impact of gender identity in the inflammatory bowel disease population: an evidence review and practical steps for gastroenterologists. Frontline Gastroenterol. 2024 Sep 1;15(5):401.
2.Wang R, Li Z, Liu S, Zhang D. Global, regional and national burden of inflammatory bowel disease in 204 countries and territories from 1990 to 2019: a systematic analysis based on the Global Burden of Disease Study 2019. BMJ Open. 2023 Mar 1;13(3):e065186.
3.LGBT+ Pride 2023: A 30-country Ipsos Global Advisor Survey [Internet]. IPSOS; 2023 Jun [cited 2024 Oct 1]. Available from: https://www.ipsos.com/sites/default/files/ct/news/documents/2023-05/Ipsos%20LGBT%2B%20Pride%202023%20Global%20Survey%20Report%20-%20rev.pdf