In the Journals Plus

Health care coverage lacking for transgender adults

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March 8, 2018

Transgender adults are more likely to report poorer cardiometabolic health and a lack of health care coverage compared with adults who did not report they are transgender, study data show.

Natalie J. Nokoff, MD, a fellow instructor at Children’s Hospital Colorado in Aurora, and colleagues evaluated data from the 2015 Behavioral Risk Factor Surveillance System survey to compare health status and prevalence of cardiometabolic disease among subgroups of transgender individuals — transitioning from female to male (n = 239; aged 35-44 years, 37.2%), transitioning from male to female (n = 369; aged 35-44 years, 13%) and gender nonconforming (n = 156; aged 35-44 years, 11.1%) — to a group who do not identify as transgender (cisgender; n = 166,295; aged 35-44 years, 16.1%).

The odds for lacking health care coverage were significantly greater among all transgender participants compared with cisgender participants (OR = 1.7; 95% CI, 1.2-2.5). No differences were observed between transgender and cisgender participants for odds of reported overweight/obesity, hypertension, myocardial infarction, angina/coronary heart disease, stroke or diabetes.

Participants transitioning from female to male were significantly more likely to lack health care coverage compared with cisgender women (OR = 3.8; 95% CI, 2.1-7.1) and cisgender men (OR = 2.5; 95% CI, 1.4-4.7). No differences were observed between these groups for self-reported cardiometabolic factors.

Participants transitioning from male to female and cisgender participants had no significant differences in health care coverage. Binge drinking was more likely among participants transitioning from male to female compared with cisgender women (OR = 2.2; 95% CI, 1.3-3.6), but not cisgender men. The odds of reporting an MI were higher among participants transitioning from male to female compared with cisgender women (OR = 2.9; 95% CI, 1.6-5.3), but not cisgender men.

Participants who reported they were gender nonconforming with a recorded female sex had higher odds of reporting that their mental health was not good 14 or more days out of the last 30 days (OR = 5.3; 95% CI, 2.03-13.7), that poor physical or mental health prevented usual activities for 14 or more days out of the last 30 days (OR = 7.1; 95% CI, 1.8-27.6) and that it had been more than a year since their last routine checkup (OR = 3.8; 95% CI, 1.6-8.9) compared with cisgender women.

“There are significant differences in health status measures and cardiometabolic health between subgroups of transgender individuals and cisgender individuals,” the researchers wrote. “There is a need for further research to understand the societal and medical (eg, hormone therapy) effects on these outcomes. Additionally, a growing proportion of young people identify as [gender-nonconforming] and their health status and mental and physical needs are distinct from those who identify as [transitioning from female to male] or [transitioning from male to female] and deserve further study.” – by Amber Cox

Disclosures: The authors report no relevant financial disclosures.