Health and health care access in the US transgender population health (TransPop) survey

Jamie L. Feldman, Winston Ekaprasetia Luhur, Jody L. Herman, Tonia Poteat, Ilan H. Meyer

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Probability and nonprobability-based studies of US transgender persons identify different disparities in health and health care access. Objectives: We used TransPop, the first US national probability survey of transgender persons, to describe and compare measures of health and health access among transgender, nonbinary, and cisgender participants. We directly compared the results with 2015 US Transgender Survey (USTS) data and with previously published analyses from the Behavioral Risk Factor Surveillance System (BRFSS). Methods: All participants were screened by Gallup Inc., which recruited a probability sample of US adults. Transgender people were identified using a two-step screening process. Eligible participants completed self-administered questionnaires (transgender n = 274, cisgender n = 1162). We obtained weighted proportions/means, then tested for differences between gender groups. Logistic regression was performed to evaluate associations. Bivariate analyses were conducted using the weighted USTS data set for shared variables in USTS and TransPop. Results: Transgender participants were younger and more racially diverse compared to the cisgender group. Despite equally high insurance coverage, transgender people more often avoided care due to cost concerns. Nonbinary persons were less likely to access transgender-related health care providers/clinics than transgender men and women. Transgender respondents more often rated their health as fair/poor, with more frequently occuring poor physical and mental health days compared to cisgender participants. Health conditions including HIV, emphysema, and ulcer were higher among transgender people. TransPop and USTS, unlike BRFSS-based analyses, showed no differences in health or health access. Discussion: Transgender persons experience health access disparities centered on avoidance of care due to cost beyond insured status. Health disparities correspond with models of minority stress, with nonbinary persons having distinct health/health access patterns. Despite different sampling methods, USTS and TransPop appear more similar than BRFSS studies regarding health/health access. Conclusion: Future research should elucidate health care costs for transgender and nonbinary people, while addressing methodology in national studies of transgender health.

Original languageEnglish (US)
JournalAndrology
Early online dateMay 25 2021
DOIs
StatePublished - Jun 10 2021

Bibliographical note

Publisher Copyright:
© 2021 American Society of Andrology and European Academy of Andrology

Keywords

  • access to care
  • health
  • nonbinary
  • probability sample
  • transgender

PubMed: MeSH publication types

  • Journal Article

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