TRAM1L1 (translocation associated membrane protein 1 like 1) is a protein located on chromosome 4 that functions in endoplasmic reticulum (ER) membrane protein insertion and translocation of secretory proteins 1. The gene encodes a protein with established roles in protein binding and ER membrane interactions [GO annotations provided]. While TRAM1L1's primary biochemical function relates to ER protein translocation, genetic association studies have identified variants near TRAM1L1 linked to complex disease phenotypes. A genome-wide association study identified a significant association between the rs76957229 SNP near TRAM1L1 and Coprococcus comes abundance in the gut microbiome, with reduced C. comes levels observed in chr4 widespread pain cases 1. Additionally, variants downstream of TRAM1L1 (rs34043524) were associated with right lateral ventricular volume and lifetime alcohol abuse or dependence in a PTSD cohort, with both TRAM1L1 and associated genes implicated in neuronal function 2. Somatic mutations in TRAM1L1 have been identified exclusively in embryonal carcinoma subtype of testicular germ cell tumors 3. These findings suggest TRAM1L1 genetic variation may influence both gut microbiota composition and brain volume phenotypes relevant to psychiatric and pain conditions, though mechanisms remain unclear.