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