Individual factors linked to experiences of health care discrimination among transgender people

Prejudice and discrimination against transgender individuals has been widely reported, and these negative views and actions persist in health care settings. More than 70% of transgender men report delaying health care due to fear of discrimination from health care providers (Newfield et al., 2006), and doctors have been found to have somewhat negative perceptions of transgender women (Lombardi, 2001). Medical professionals may lack knowledge and training in transgender-specific health, which forces patients to educate their providers about their needs and concerns (Bockting et al., 1998; Dean et al., 2000). Transgender individuals may also avoid accessing health care due to the perceived insensitivity of health care providers. Referring to transgender patients by incorrect pronouns or refusing to acknowledge their gender identity may alienate these patients, and further points to the lack of cultural competence among some health professionals (Lombardi, 2001). This study uses data from the National Transgender Discrimination Survey to explore individual factors associated with experiences of discrimination by health care providers in a non-probability sample of 4,037 transgender participants (212 Latinos, 127 Blacks, 54 American Indians, 69 Asians, 145 Multi-racial and 3,430 Whites). Binomial logistic regression analyses indicate that individual characteristics and socioeconomic status were highly associated with experiences of discrimination in health care settings. Those who avoided or postponed getting medical care due to discrimination from health care providers were more likely to be Latino/a, American Indian, Multi-racial, female-born, queer identified, and younger. Those who were refused treatment by health care providers due to being transgender were more likely to be female-born, gender-conforming, gay-identified, and queer-identified transgender individuals. Additionally, those who reported that they had to educate health care providers about transgender people in order to get care were more likely to be American Indian, multi-racial, and younger. History of transitional procedures, education, low income and lack of insurance were factors significantly associated with the four aspects of health care discrimination examined in the study. Findings suggest that individual factors associated with minority status increase the likelihood of experiencing discrimination in health care. This could have detrimental consequences, particularly for those undergoing transitional procedures that are not receiving proper medical guidance. Health care providers will highly benefit from sensitivity training to meet the needs of an underserved population.