Sexual orientation, gender identity and cardiometabolic risk: a narrative review – Published online 21/10/2025

Meredith S. Duncan, Lauren B. Beach, Hill L. Wolfe, Arjee Restar, Adovich S. Rivera, Carl G. Streed Jr

Approximately 9% of adults globally identify as a sexual and gender minority (SGM). Although CVD is the leading cause of death worldwide, few studies have investigated cardiometabolic health in SGM populations, particularly with regard to diabetes and its sequelae. In this issue, Duncan and Beach et al (https://doi.org/10.1007/s00125-025-06572-7) summarise the field of cardiometabolic epidemiology in SGM populations in the UK and USA. The authors highlight that UK studies have found that sexual minority women have an increased risk of diabetes compared with heterosexual women, while US studies report ambiguous results depending on the data source. Studies investigating diabetes in transgender adults have found an increased risk compared with cisgender comparators in the UK but not in the USA. In both contexts, transgender adults have been found to have an increased CVD risk. The authors conclude that longitudinal cohort studies explicitly inclusive of SGM populations are needed to better characterise the epidemiology of cardiometabolic risk factors and conditions in SGM populations globally. The figure from this review is available as a downloadable slide

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