142nd APHA Annual Meeting and Exposition

Annual Meeting Recordings are now available for purchase

Legal protections in public accommodations settings: A critical public health issue for transgender adults in Massachusetts

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014 : 3:15 PM - 3:30 PM

Sari Reisner, ScD , Epidemiology/ The Fenway Institute, Harvard School of Public Health/ Fenway Health, Boston, MA
Jaclyn White, MPH , Epidemiology Department, The Fenway Institute, Fenway Health, Boston, MA
Emilia Dunham , The Fenway Institute, Fenway Health, Boston, MA
Jesse Begenyi , Massachusetts Transgender Political Coaltion (MTPC), Boston, MA
Katherine Heflin , Department of Health Policy and Management/ The Fenway Institute, Harvard School of Public Health/ Fenway Health, Boston, MA
Sean Cahill, PhD , Fenway Institute, Boston, MA
Background: Transgender and gender non-conforming (trans) people experience widespread discrimination and health inequities. Since 2012, trans people in Massachusetts have had legal protections in employment and housing. However, the state law does not offer legal protections in public accommodations, which includes healthcare settings. This study sought to examine the frequency and health correlates of public accommodations discrimination in Massachusetts.

Methods: A community-based sample (n=452) was purposively recruited in 2013 using bi-model methods (online and in-person). Respondents completed a brief, one-time quantitative survey. Multivariable logistic regression models estimated Risk Ratios (RR) and 95% Confidence Intervals (95% CI) to examine whether experiencing public accommodation discrimination during the past 12-months was associated with adverse self-reported health in the past 30 days, including negative physical and emotional symptoms. Models were adjusted for age, gender identity, hormones, surgical status, visual gender nonconformity, race/ethnicity, income, education, employment, health insurance and data collection method.

Results: Overall, 65% of respondents reported public accommodations discrimination in the past 12 months. The five most prevalent discrimination settings were transportation (36%), retail (28%), restaurant (26%), public gathering (25%), and healthcare (24%). Public accommodations discrimination was associated with approximately two-fold increased risk of adverse physical (RR=1.84; 95% CI=1.21-2.79) and emotional (RR=1.99; 95% CI=1.29-3.06) symptoms in past 30 days.

Conclusion: Public accommodations discrimination is associated with adverse physical and emotional health among trans adults in Massachusetts. Passage and enforcement of trans rights laws that include protections in public accommodations is a critical public health policy approach needed to address trans health inequities.

Learning Areas:

Assessment of individual and community needs for health education
Public health or related public policy
Social and behavioral sciences

Learning Objectives:
Describe the frequency and health correlates of public accommodations discrimination experienced by transgender adults sampled in Massachusetts. Assess whether public accommodations discrimination is associated with physical and emotional symptoms. Discuss the implications of findings for public health policy, research, and practice.

Keyword(s): Public Health Policy, Health Disparities/Inequities

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Dr. Reisner is a Research Scientist at the Fenway Institute at Fenway Health and a Postdoctoral Research Fellow at Harvard School of Public Health. He is trained as a social epidemiologist in LGBT population health disparities, with a specialization in national and global transgender and gender nonconforming health. He has authored more than 60 peer-reviewed publications in sexual and gender minority health, is a faculty member of the National LGT Health Education Center.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.