Improved Lung Function Testing for Transgender People

Mr Finn Chilcott has presented findings from his 2024 Nursing and Allied Health Grant to the Thoracic Society of Australia and New Zealand and the Australian and New Zealand Society of Respiratory Science (TSANZSRS) 2026 conference.

There is currently limited research into transgender and gender diverse health. There has been a rapid increase in the number of transgender people seeking healthcare. Many people in this population still face numerous barriers when accessing healthcare which can lead to them avoiding healthcare.

Compared to the general population, these individuals have higher rates of smoking, mental health challenges and importantly, an increased prevalence of respiratory disease. Therefore, understanding how to accurately assess respiratory health in this population is critical.

The GLI reference equations for lung function testing provide separate predicted values for males and females. When we have a transgender or gender diverse patient, there is uncertainty about which reference equation we should select. The current international guidelines recommend applying the GLI reference equations for assigned sex at birth; however, this is not supported by direct evidence, and there is a significant gap in the literature with no published data on diffusing capacity or total lung capacity in TGD people, nor data on how gender affirming therapies may affect this groups lung function, which motivated this research project.

To help address this gap, Mr Chilcott studied 56 transgender and/or gender diverse participants, measuring lung size and how well the lungs transfer oxygen into the blood.

The study found that using sex assigned at birth provides accurate results when measuring lung size. However, for how efficiently the lungs transfer oxygen, using the opposite reference values may be more appropriate. This suggests that gender-affirming hormone therapy may influence how efficiently the lungs transfer oxygen.

This is the first study to provide direct evidence supporting current guidelines for measuring lung size in transgender and/or gender diverse people. However, it also highlights that a different approach may be needed for assessing how well the lungs transfer oxygen.

Mr Finn Chilcott was awarded the New Investigator Award at the (TSANZSRS) 2026 conference in recognition of his valuable work on this project.

The RPH Research Foundation is proud to support Mr Chilcott and his work to improve lung function testing for the transgender and gender diverse population.