“My PCP has virtually no idea how to treat transgender patients” Findings from a Survey of Transgender and Gender Non-Conforming Individuals in Arkansas

Purpose:  Transgender and gender non-conforming (T/GNC) individuals face many forms of discrimination affecting their health, many of which relate to access to care. Experiences of this population vary widely across the United States, with substantially more barriers in rural and/or Southern regions.

Methods:  We conducted an online health needs survey of T/GNC adults in Arkansas in Fall 2013 using an instrument adapted from the National Transgender Discrimination Survey. Participants were recruited through social media, special events and provider offices. Data were analyzed using STATA to produce descriptive statistics and to test associations using the Fisher exact test. 

Results:  Eighty-four self-identified T/GNC individuals completed the full survey. Thirty-seven percent were not covered by health insurance; 33% reported postponing either medically needed or preventive healthcare due to discrimination on the part of a healthcare provider; 19% had been refused treatment by a healthcare provider; and 39% reported having to teach their medical provider about T/GNC people in order to receive appropriate care.  Seventy-seven percent reported having seriously considered suicide, while 43% reported an actual suicide attempt. When asked to rank their top policy priorities, the top two priorities dealt with obtaining appropriate healthcare. 

Conclusions:  We found widespread discrimination from healthcare providers, substantial barriers to access, and significant deficits in providers’ knowledge of how to provide quality care for these T/GNC respondents. These results have informed organizing efforts of the T/GNC community and allies in Arkansas concerned with improving healthcare access and provider knowledge and understanding.