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. 2018 May 23;35(3):302-306.
doi: 10.1093/fampra/cmx112.

Primary care access and foregone care: a survey of transgender adolescents and young adults

Beth A Clark  1 , Jaimie F Veale  2 , Devon Greyson  3 , Elizabeth Saewyc  1
Affiliations

Primary care access and foregone care: a survey of transgender adolescents and young adults

Beth A Clark et al. Fam Pract. .

Abstract

Objective: To examine the issues of primary care access and foregone health care among transgender adolescents and young adults.

Methods: This cross-sectional analysis of data from the Canadian Trans Youth Health Survey was conducted online during 2013-2014. Participants included 923 youth aged 14-25 (323 adolescents aged 14-18 and 600 young adults aged 19-25). Main outcome measures were self-reported general and mental health status, comfort discussing transgender identity and health care needs with general practitioners, and types of and reasons for self-identified foregone health care.

Results: Most youth reported poor/fair general and mental health status. Comfort with a family doctor was positively correlated with both general health (r(528) = 21, P < 0.001) and mental health (r(450) = 26, P < 0.001) status, as was having a doctor who was aware of one's transgender status. 47.2% (n = 219) of young adults reported foregoing needed health care. Among adolescents, levels of comfort with family doctor were negatively correlated with foregone mental health care in the previous 12 months (F3,166 = 3.829, P = 0.011), but not correlated with foregone physical health care (F3,165 = 0.506, P = 0.679). Reasons for missing needed care spanned the dimensions of health care access, ranging from cost barriers to previous negative experiences with health care providers, and concerns that a doctor would be uneducated about transgender people.

Conclusion: General practitioners can play a key role in improving the health of transgender youth by demonstrating understanding of the health care needs of transgender youth and competence in gender-affirming care, and by ensuring that their practices are accessible to all transgender youth in need of care.

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