Introduction
Transgender and nonbinary individuals experience high levels of health disparities
and are more likely to experience denials of health care than their cisgender (nontransgender)
counterparts. There is a lack of evidence on how healthcare denials vary by gender
identity and other intersecting identity characteristics in the transgender and nonbinary
populations.
Methods
Using data from the 2015 U.S. Trans Survey (n=27,715), multivariate logistic regressions were used to analyze (in 2019) the increased
likelihood of experiencing denials of trans-related care and standard care across
socioeconomic and identity characteristics among the transgender and nonbinary population,
including race, age, educational attainment, disability, income, and gender identity.
Results
Almost 8% of the participants had been denied trans-specific health care, and >3%
had been refused general health care. Transgender (compared with nonbinary), older,
biracial, or multiracial, and lower-income participants, as well as those with less
than a high school diploma and those with disabilities, were significantly more likely
to experience refusal of care in general or trans-specific healthcare settings.
Conclusions
There is a need for better training of healthcare providers to be inclusive and reduce
denial rates of their transgender and nonbinary patients. However, it is also clear
that current rates of denial must be considered through a whole-person lens, considering
the experience of concurrent oppressed identities and recognizing the increased risk
those with multiple marginalized identities experience in being denied needed health
care.
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Article Info
Publication History
Published online: January 28, 2020
Identification
Copyright
© 2020 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
