The goal of this observational study is to learn how common headache and migraine are and to describe headache patterns among transgender adults in Thailand. The main questions it aims to answer are: * How common are headache and migraine among transgender adults in Thailand? * What headache patterns and levels of headache-related disability do participants report? * Are gender-affirming hormone therapy, gender-affirming surgery, or HIV pre-exposure prophylaxis (PrEP) use related to headache or migraine? About 500 transgender adults aged 18 years or older who currently attend or previously attended the Tangerine Clinic in Bangkok, Thailand, will take part. Participants will: * Provide consent online * Complete an online questionnaire about their general health and headache symptoms * Answer questions about gender-affirming hormone therapy, gender-affirming surgery, and PrEP use * Complete questionnaires that screen for migraine and measure how headaches affect daily activities This study will not assign any treatment or change the participants' usual medical care.
Study Type
OBSERVATIONAL
Enrollment
500
Current or previous use of gender-affirming hormone therapy as part of the participant's usual care. Information about medication name, dose, route, frequency, duration, and adherence will be collected through an online questionnaire. The researchers will not assign or modify hormone therapy.
History of gender-affirming surgery received as part of the participant's usual care. The type and date of surgery will be collected through an online questionnaire. No surgical procedure will be assigned or performed as part of this study.
Current or previous use of HIV pre-exposure prophylaxis as part of the participant's usual care. Information about PrEP use will be collected through an online questionnaire. The researchers will not prescribe or modify PrEP as part of this study.
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Bangkok, Thailand
Prevalence of Headache
Number and percentage of participants who report headache in 1 year based on the structured online headache questionnaire.
Time frame: At enrollment during the one-time online questionnaire
Clinical Characteristics of Headache
Number and percentage of participants reporting headache characteristics, including headache location, pain quality, aggravation by physical activity, nausea or vomiting, sensitivity to light, sensitivity to sound, aura symptoms, and reported headache triggers.
Time frame: At enrollment during the one-time online questionnaire
Prevalence of Migraine
Number and percentage of participants who screen positive for migraine based on the ID Migraine and American Migraine Prevalence and Prevention/American Migraine Study questionnaires.
Time frame: At enrollment during the one-time online questionnaire
Headache-Related Disability Assessed Using the Migraine Disability Assessment Questionnaire
Headache-related disability measured using the total Migraine Disability Assessment (MIDAS) score. Higher scores indicate greater headache-related disability.
Time frame: During the 3 months before enrollment
Association Between Gender-Affirming Hormone Therapy Use and Headache
Association between current or previous gender-affirming hormone therapy (GAHT) use and the presence of headache, as assessed by a self-reported headache item in the study questionnaire. The association will be estimated using logistic regression and reported as an odds ratio with a 95% confidence interval. Unit of Measure: Odds ratio
Time frame: At enrollment during the one-time online questionnaire
Association Between Gender-Affirming Surgery and Headache
Association between a history of gender-affirming surgery and the presence of headache, as assessed by a self-reported headache item in the study questionnaire. The association will be estimated using logistic regression and reported as an odds ratio with a 95% confidence interval. Unit of Measure: Odds ratio
Time frame: At enrollment during the one-time online questionnaire
Association Between HIV Pre-Exposure Prophylaxis Use and Headache
Association between current or previous HIV pre-exposure prophylaxis (PrEP) use and the presence of headache, as assessed by a self-reported headache item in the study questionnaire. The association will be estimated using logistic regression and reported as an odds ratio with a 95% confidence interval. Unit of Measure: Odds ratio
Time frame: At enrollment during the one-time online questionnaire
Association Between Gender-Affirming Hormone Therapy Use and Migraine
Association between current or previous gender-affirming hormone therapy (GAHT) use and the presence of migraine, assessed using the ID Migraine and American Migraine Prevalence and Prevention/American Migraine Study questionnaires.. The association will be estimated using logistic regression and reported as an odds ratio with a 95% confidence interval. Unit of Measure: Odds ratio
Time frame: At enrollment during the one-time online questionnaire
Association Between Gender-Affirming Surgery and Migraine
Association between a history of gender-affirming surgery and the presence of migraine, as assessed by the ID Migraine and American Migraine Prevalence and Prevention/American Migraine Study questionnaires. The association will be estimated using logistic regression and reported as an odds ratio with a 95% confidence interval. Unit of Measure: Odds ratio
Time frame: At enrollment during the one-time online questionnaire
Association Between HIV Pre-Exposure Prophylaxis Use and Migraine
Association between current or previous HIV pre-exposure prophylaxis (PrEP) use and the presence of migraine, as assessed by the ID Migraine and American Migraine Prevalence and Prevention/American Migraine Study questionnaires. The association will be estimated using logistic regression and reported as an odds ratio with a 95% confidence interval. Unit of Measure: Odds ratio
Time frame: Time Frame: At enrollment during the one-time online questionnaire
Sirawit Roongrojwittayakul, M.D.
CONTACT
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