TY - JOUR
T1 - Access to Health Care for Transgender and Gender-Diverse Adults in Urban and Rural Areas in the United States
AU - MacDougall, Hannah
AU - Henning-Smith, Carrie
AU - Gonzales, Gilbert
AU - Ott, Austen
N1 - Publisher Copyright:
© The Author(s) 2023.
PY - 2024/2
Y1 - 2024/2
N2 - The objective of this study is to examine access to care based on gender identity in urban and rural areas, focusing on transgender and gender diverse (TGD) populations. Data on TGD (n = 1,678) and cisgender adults (n = 403,414) from the 2019 to 2020 Behavioral Risk Factor Surveillance System were used. Outcome measures were four barriers to care. We conducted bivariate and multivariable logistic regressions to assess associations between access, rurality, and gender identity. Bivariate results show that TGD adults were significantly more likely to experience three barriers to care. In multivariable models, TGD adults were more likely to delay care due to cost in the full sample (adjusted odds ratio [AOR]: 2.00, p <.001), rural subsample (AOR: 2.14, p <.01), and urban subsample (AOR: 1.97, p <.01). This study revealed greater barriers to care for TGD adults, with the most frequent barriers found among rural TGD adults. Increased provider awareness and structural policy changes are needed to achieve health equity for rural TGD populations.
AB - The objective of this study is to examine access to care based on gender identity in urban and rural areas, focusing on transgender and gender diverse (TGD) populations. Data on TGD (n = 1,678) and cisgender adults (n = 403,414) from the 2019 to 2020 Behavioral Risk Factor Surveillance System were used. Outcome measures were four barriers to care. We conducted bivariate and multivariable logistic regressions to assess associations between access, rurality, and gender identity. Bivariate results show that TGD adults were significantly more likely to experience three barriers to care. In multivariable models, TGD adults were more likely to delay care due to cost in the full sample (adjusted odds ratio [AOR]: 2.00, p <.001), rural subsample (AOR: 2.14, p <.01), and urban subsample (AOR: 1.97, p <.01). This study revealed greater barriers to care for TGD adults, with the most frequent barriers found among rural TGD adults. Increased provider awareness and structural policy changes are needed to achieve health equity for rural TGD populations.
KW - health access
KW - rural
KW - transgender
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U2 - 10.1177/10775587231191649
DO - 10.1177/10775587231191649
M3 - Article
C2 - 37545340
AN - SCOPUS:85167419481
SN - 1077-5587
VL - 81
SP - 68
EP - 77
JO - Medical Care Research and Review
JF - Medical Care Research and Review
IS - 1
ER -
