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Transgend Health. 2017 Jul 1;2(1):107-118. doi: 10.1089/trgh.2017.0014. eCollection 2017.

Barriers to Gender Transition-Related Healthcare: Identifying Underserved Transgender Adults in Massachusetts.

Author information

1
Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut.
2
The Fenway Institute, Fenway Health, Boston, Massachusetts.
3
RAND Corporation, Boston, Massachusetts.
4
Section of General Internal Medicine, Boston University School of Medicine, Boston, Massachusetts.
5
Division of General Pediatrics/Harvard Medical School, Boston Children's Hospital, Boston, Massachusetts.
6
Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.

Abstract

Purpose: The present study sought to examine whether individual (e.g., age, gender), interpersonal (e.g., healthcare provider discrimination), and structural (e.g., lack of insurance coverage) factors are associated with access to transition-related care in a statewide sample of transgender adults. Method: In 2013, 364 transgender residents of Massachusetts completed an electronic web-based survey online (87.1%) or in person (12.9%). A multivariable logistic regression model tested whether individual, interpersonal, and structural factors were associated with access to transition-related care. Results: Overall, 23.6% reported being unable to access transition-related care in the past 12 months. In a multivariable model, younger age, low income, low educational attainment, private insurance coverage, and healthcare discrimination were significantly associated with being unable to access transition-related care (all p<0.05). Discussion: Despite state nondiscrimination policies and universal access to healthcare, many of the Massachusetts transgender residents sampled were unable to access transition-related care. Multilevel interventions are needed, including supportive policies and policy enforcement, to ensure that underserved transgender adults can access medically necessary transition-related care.

KEYWORDS:

access to care; gender transition; health policy; transgender health

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