State Policies and Healthcare Use among Transgender People in the U.S.

Citation

Goldenberg, Tamar; Reisner, Sari L.; Harper, Gary W.; Gamarel, Kristi E.; & Stephenson, Rob (2020). State Policies and Healthcare Use among Transgender People in the U.S.. American Journal of Preventive Medicine, 59(2), 247-259. PMCID: PMC7384261

Abstract

Introduction: The introduction and passing of restrictive and protective transgender-specific state policies has increased over the past decade. These policies are critical for the health of transgender and other gender diverse (TGGD) people; however, little is known about the relationship between these policies and healthcare use, and the role that race/ethnicity plays in this relationship.
Methods: Analysis was conducted in 2018-2019 using multilevel modeling and data from the 2015 U.S. Trans Survey (conducted by the National Center for Transgender Equality among nearly 28,000 TGGD people across the United States) to explore associations between transgender-specific state policies and healthcare avoidance due to fears of mistreatment. State policies included those related to experiences of discrimination, health insurance coverage, and changing legal documents. Restrictive and protective policies were measured individually and as a composite index. The relationship between race/ethnicity and healthcare use was also examined to determine if there were differences in the association between race/ethnicity and healthcare avoidance by state.
Results: None of the individual policies were associated with healthcare use, but the composite policy index was significant, such that living in states with more protective policies was associated with reduced odds of avoiding healthcare due to fears of mistreatment. The relationship between race/ethnicity and healthcare also varied across states.
Conclusions: Findings suggest the importance of advocating for more protective transgender-specific policies to improve healthcare access for TGGD people in the United States, particularly for TGGD people of color.

URL

http://dx.doi.org/10.1016/j.amepre.2020.01.030

Reference Type

Journal Article

Year Published

2020

Journal Title

American Journal of Preventive Medicine

Author(s)

Goldenberg, Tamar
Reisner, Sari L.
Harper, Gary W.
Gamarel, Kristi E.
Stephenson, Rob

Article Type

Regular

PMCID

PMC7384261

Data Set/Study

U.S. Trans Survey

Continent/Country

United States of America

Sex/Gender

Transgender Women
Transgender Men
Gender Non-Binary

ORCiD

Goldenberg - 0000-0003-3998-2913