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Recorded Annual Meeting Presentations (RAMP) are now available for purchase.
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Online Program

323210
Barriers to Transition-Related Healthcare among Transgender Adults in Massachusetts


Tuesday, November 3, 2015 : 4:43 p.m. - 4:56 p.m.

Jaclyn White Hughto, MPH, PhD-C, Chronic Disease Epidemiology, Yale University, New Haven, CT
Sari Reisner, ScD, Epidemiology/ The Fenway Institute, Harvard School of Public Health/ Fenway Health, Boston, MA

Emilia Dunham, The Fenway Institute, Fenway Health, Boston, MA
John Pachankis, Ph.D., Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT
  
Audio (mp3) recording Recorded Presentation (mp4)
Background: Accessing hormones, surgeries, and other transition-related procedures are medically necessary for many transgender people. In Massachusetts, policies have been passed to remove enacted discrimination and structural barriers like insurance coverage to transition-related care; however, it is unclear whether these barriers persist for transgender people seeking medically necessary care despite legal reforms.

Methods: In 2013, transgender residents of Massachusetts completed a cross-sectional electronic survey (analytic sample n=364). An age-adjusted multivariable logistic regression model examined associations between demographics, insurance coverage, discrimination in healthcare, and access to transition-related care in the past 12 months (outcome).  

 

Results: Participants had a mean age of 33 (SD=13), 82% were non-Hispanic White and 24% reported being unable to access transition-related care in the past 12 months. Overall, 63% had private insurance, 32% had public insurance, and 5% had none. Factors significantly associated with being unable to access transition-related care in the past 12 months were: lower educational attainment, having private or no insurance compared to public insurance, lack of coverage for mental healthcare services, experiencing discrimination in a healthcare setting - past 12 months, postponing preventative or emergency care due to discrimination - past 12 months, and delaying preventative or emergency care - past 12 months (all p<0.05).

 

Conclusion: Transgender people in Massachusetts experience discrimination in healthcare settings and have inadequate insurance coverage for transition-related care – experiences that are highly associated with lack of access transition-related care. Multi-level interventions are needed to eliminate discrimination in healthcare and ensure access to insurance coverage for transition-related care.

Learning Areas:

Assessment of individual and community needs for health education
Diversity and culture
Public health or related laws, regulations, standards, or guidelines

Learning Objectives:
Describe past year access to transition-related care among transgender adults. Identify barriers to accessing transition-related care among transgender adults. Discuss policy implications of transition-related care barriers for transgender adults.

Keyword(s): Health Care Access, Special Populations

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the co-principal investigator and project manager of multiple federal and industry-funded studies to improve the mental and sexual health of sexual and gender minority populations. My research interests include HIV/AIDS prevention and treatment, substance abuse, mental health and LGBT health.
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.

Back to: 4433.0: Trans/Gender-variant People's Public Health