Health Care Access and Utilization by Transgender Populations: A United States Transgender Survey Study

Abstract

Purpose: There is little research examining disparities among subcategories of lesbian, gay, bisexual, transgender, and queer people who identify as transgender. The purpose of this study is to elucidate health disparities regarding access to and utilization of health care and experiences with discrimination within the transgender community. Methods: The United States Transgender Survey (USTS) was conducted online between January and December of 2015. The survey included questions about health care access, utilization, and discrimination. Chi-squared tests were used to identify differences in demographic variables among transfeminine (TF), transmasculine (TM), and nonbinary (NB) participants. Logistic regression was used to analyze differences in health care access, utilization, and discrimination between the three groups. Results: A total of 27,715 transgender-identifying people participated in the survey. TF and TM individuals were more likely to report postponement of health care utilization due to fear of discrimination and had experienced discrimination in the health care setting than NB respondents. NB respondents were more likely to delay care due to cost. Conclusions: Results from this USTS analysis indicate the need for medical education, policy implementation, and intersectional research to establish health equity for transgender people.

Keywords: access to care; health disparities; nonbinary gender identity; transgender.