P1220Gender Identity and Inflammatory Bowel Disease: A National Bioresource Study Reveals Delayed Diagnosis, Greater Comorbidity and Poorer Quality of Life

Background Transgender or gender non-conforming (TGNC) individuals frequently experience stigma and poor health outcomes, have high rates of comorbidity, express dissatisfaction in healthcare and are under-represented in healthcare research.[1,2] Despite greater societal awareness of gender identity, little is known about the interplay between a minority gender identity and chronic disease. Inflammatory bowel disease (IBD) is a common chronic immune mediated disorder of the gastrointestinal tract associated with significant physical and psychological morbidity and can significantly impact upon quality of life. There is extremely limited data on the implications of identifying as TGNC and suffering from IBD (TGNC-IBD) particularly with regards to the impact upon time to diagnosis, disease outcomes such as rates of surgery, and quality of life. Methods A questionnaire, designed in collaboration with TGNC-IBD individuals, was distributed through the NIHR IBD Bioresource in the United Kingdom to approximately 47,000 individuals. Data was collected from adult individuals identifying as TGNC via on online portal on demographics, IBD and other medical history and quality of life indices. Data was also collected from an age and sex matched cisgender control cohort. Continuous and ordinal variables were compared with the Mann-Whitney test, categorical with chi-square test. Results 39 individuals identified as TGNC and provided survey responses, demographic details are in table 1. Mean time to diagnosis from the onset of symptoms was 26.5 months compared to 24.0 in the control group (p = 0.70), rate of a history of hospitalisation for IBD was 62.3% compared to 53.9% (Odds ratio (OR) 1.44 p = 0.47), and rates of history of surgery for IBD were 28.6% compared to 21.6% in controls (OR 1.44, p = 0.45) (figure 1). A concurrent psychiatric diagnosis was reported in 79% of TGNC-IBD respondents compared to 50% of controls (p = 0.0024). TGNC-IBD individuals reported a greater negative impact of their IBD on their normal day-to-day activities (p = 0.037), their ability to attend social events (p = <0.001) or to leave their house without a toilet nearby (p = 0.013) compared to controls and a numerically greater but not significant impact upon overall quality of life (p = 0.087). Conclusion This is the first nationwide study investigating TGNC-IBD individuals and represents the largest single data set of this minority in the world. Despite relatively small numbers, the data demonstrates a significantly worse impact of IBD on their quality of life and psychiatric comorbidity as well as numerically longer time to diagnosis and higher rates of surgery and hospitalisation suggesting poorer IBD care for these individuals. Further research with longitudinal studies is required. References: 1. Colwill M, Jacob K, Pollok R, Seal L, Poullis A. Patient experiences of gender identity and inflammatory bowel disease: a focus group study. Frontline Gastroenterology 2025. https://doi.org/10.1136/flgastro-2025-103103 2. Ghorbanian A, Aiello B, Staples J. Under-Representation of Transgender Identities in Research: The Limitations of Traditional Quantitative Survey Data. Transgend Health 2022;7:261–9. https://doi.org/10.1089/trgh.2020.0107 Conflict of interest: Dr. Colwill, Michael: Michael Colwill has received speaker fees or travel grants from Celltrion, Pfizer, Dr Falk, Takeda, Johnson & Johnson and Ferring. Pollok, Richard: No conflict of interest Hall, Richard: No conflict of interest Povlsen, Sebastian: No conflict of interest Seal, Leighton: No conflict of interest Poullis, Andrew: No conflict of interest