Ask the Expert Webinar: Caring for All - LGBTQ+ Informed Care in Epilepsy-ATEW001

Video Transcription

Video Summary

The webinar “Caring for All: LGBTQ+ Informed Care and Epilepsy” reviews disparities and practical strategies for inclusive epilepsy care. Dr. Emily Johnson summarizes evidence that sexual and gender minority (SGM), including transgender and gender-diverse (TGD), people experience higher mortality, markedly higher suicidality, and worse health outcomes. Population surveys suggest epilepsy prevalence is about twice as high in SGM individuals, with higher depression rates, more poverty, poorer seizure control, and lower likelihood of feeling respected by health providers—especially among LGBTQ+ people with epilepsy. Contributing factors include barriers to care, minority stress, stigma, and possible medication–hormone interactions.<br /><br />Clinical considerations include how gender-affirming hormones may interact with anti-seizure medications (e.g., estrogen can lower lamotrigine levels; enzyme inducers may reduce estrogen/testosterone). Higher estrogen doses used in gender-affirming therapy may affect seizure frequency, though data are limited. The speakers also address the changing legal landscape, privacy concerns, and risks of patients avoiding care or using unregulated hormones.<br /><br />Dr. Rodrigo Zepeda presents cases highlighting avoiding assumptions (pronouns, sexual partners, reproductive risk, organ inventory), preventing “trans broken arm syndrome,” and supporting patients facing coming-out stress that can worsen seizures. Monitoring strategies mirror cisgender hormone interactions, with dose adjustments and level checks.

Keywords

LGBTQ+ informed care

inclusive epilepsy care

sexual and gender minority (SGM) health disparities

transgender and gender-diverse (TGD) patients

suicidality and mental health in epilepsy

minority stress and stigma barriers to care

gender-affirming hormone therapy interactions

anti-seizure medications and lamotrigine estrogen interaction

trans broken arm syndrome and clinical communication