Headache Treatments

The Transgender Headache Medicine Program at Mount Sinai provides excellent comprehensive care for transgender and gender-diverse people who suffer from migraine and other headache syndromes.

Our mission is to provide personalized headache medicine care that addresses each individual’s unique needs, and to also increase access to comprehensive headache care services for the LGBTQIA+ community.

Transgender and gender-diverse people can experience various types of headaches throughout their lifetime. The most common type of headache that may bring a patient to see a specialist is migraine. Migraine is often a lifelong problem, but the frequency and severity of episodes may fluctuate over time. Migraine can be debilitating and cause symptoms of light and sound sensitivity, dizziness, nausea, or vomiting, and can last for hours or days. Everyone experiences migraines differently, so treatment plans are made to suit each person’s medical needs.

The Transgender Headache Medicine Program can help to support you and uses various treatments to help reduce the frequency and severity of attacks while you are receiving gender-affirming hormone therapy (GAHT) or undergoing gender-affirming surgical interventions.

Other headache syndromes we treat include tension headaches, cluster headaches, and new daily persistent headaches. Cluster headaches and new daily persistent headaches are less common. Cluster headaches are often shorter than migraine headaches and do not cause light or sound sensitivity. New daily persistent headaches tend to last all day every day and are constant from onset.

We incorporate both pharmacologic and nonpharmacologic treatment options to care plans, offering the most advanced therapy that is evidence- and research-based. Treatment is tailored to support every stage of medical and surgical interventions. The treatments we offer include onabotulinum toxin injections for chronic migraine, peripheral nerve blocks, and trigger point injections, as well as an individualized medication plan. We work closely in a multidisciplinary team to promote a respectful, accepting, and affirming treatment environment.

Current research involves determining the true prevalence of migraines and primary headache syndromes in the transgender and gender-diverse community, and demonstrating what other various types of secondary headaches may occur. Upcoming research is looking to describe the presence or absence of aura in relation to hormone therapy, and what preventive therapies may be most useful while on GAHT.

Our goal is to train future neurologists and physicians on the unique needs of transgender and gender-diverse people who have headaches and to continue improving access to comprehensive and gender-affirming care. We are dedicated to researching new and innovative ways to treat headaches and migraine in this community.