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. 2019 Oct;34(10):2068-2074.
doi: 10.1007/s11606-019-05179-0. Epub 2019 Aug 5.

Healthcare Experiences of Transgender People of Color

Susanna D Howard  1 , Kevin L Lee  2 , Aviva G Nathan  3 , Hannah C Wenger  3 , Marshall H Chin  3 , Scott C Cook  3
Affiliations

Healthcare Experiences of Transgender People of Color

Susanna D Howard et al. J Gen Intern Med. 2019 Oct.

Abstract

Background: Transgender people and racial/ethnic minorities separately report poor healthcare experiences. However, little is known about the healthcare experiences of transgender people of color (TPOC), who are both transgender and racial/ethnic minorities.

Objective: To investigate how TPOC healthcare experiences are shaped by both race/ethnicity and gender identity.

Design and participants: Semi-structured, in-depth individual interviews (n = 22) and focus groups (2; n = 17 total); all taken from a sample of TPOC from the Chicago area. All participants completed a quantitative survey (n = 39).

Approach: Interviews and focus groups covered healthcare experiences, and how these were shaped by gender identity and/or race/ethnicity. The interviews and focus groups were audio recorded, transcribed verbatim, and imported into HyperRESEARCH software. At least two reviewers independently coded each transcript using a codebook of themes created following grounded theory methodology. The quantitative survey data captured participants' demographics and past healthcare experiences, and were analyzed with descriptive statistics.

Key results: All participants described healthcare experiences where providers responded negatively to their race/ethnicity and/or gender identity. A majority of participants believed they would be treated better if they were cisgender or white. Participants commonly cited providers' assumptions about TPOC as a pivotal factor in negative experiences. A majority of participants sought out healthcare locations designated as lesbian, gay, bisexual, and transgender (LGBT)-friendly in an effort to avoid discrimination, but feared experiencing racism there. A minority of participants expressed a preference for providers of color; but a few reported reluctance to reveal their gender identity to providers of their own race due to fear of transphobia. When describing positive healthcare experiences, participants were most likely to highlight providers' respect for their gender identity.

Conclusions: TPOC have different experiences compared with white transgender or cisgender racial/ethnic minorities. Providers must improve understanding of intersectional experiences of TPOC to improve quality of care.

Keywords: cultural competency; gay and lesbian health; primary care; race and ethnicity; underserved populations.

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Conflict of interest statement

The authors declare that they do not have a conflict of interest.

Comment in

References

    1. Grant JM, Mottet LA, Tani J, Harrison J, Herman JL, Keisling M. Injustice at every turn: a report of the national transgender discrimination survey. Washington, DC: National Center for Transgender Equality and National Gay and Lesbian Task Force (US); 2011.
    1. James SE, Herman JL, Rankin S, Keisling M, Mottet L, Anafi M. The report of the 2015 U.S. transgender survey. Washington, DC: National Center for Transgender Equality (US); 2016.
    1. Sugano E, Nemoto T, Operario D. The impact of exposure to transphobia on HIV risk behavior in a sample of transgendered women of color in San Francisco. AIDS Behav. 2006;10:217–225. doi: 10.1007/s10461-005-9040-z. - DOI - PubMed
    1. Bradford J, Reisner SL, Honnold JA, Xavier J. Experiences of transgender-related discrimination and implications for health: results from the Virginia Transgender Health Initiative Study. Am J Public Health. 2013;103:1820–1829. doi: 10.2105/AJPH.2012.300796. - DOI - PMC - PubMed
    1. Geiger HJ. Health disparities: what do we know? what do we need to know? What should we do? In: Schulz AJ, Mullings L, editors. Gender, race, class, and health: intersectional approaches. San Francisco: Jossey Base; 2006. pp. 261–288.

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