Social and Systemic Barriers to Transition-Related Surgical Procedures for Transgender Americans
Purpose: Transgender and gender-diverse (TGD) individuals in the United States face disproportionate barriers to health care access. This study compared characteristics of individuals who have and have not undergone gender-affirming surgery with the goal of identifying social and systemic barriers t...
Gespeichert in:
| Veröffentlicht in: | LGBT health 2024-12, Vol.11 (8), p.615-624 |
|---|---|
| Hauptverfasser: | , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 624 |
|---|---|
| container_issue | 8 |
| container_start_page | 615 |
| container_title | LGBT health |
| container_volume | 11 |
| creator | Marano, Andrew A Miller, Amitai S Castillo, Wendy Reisner, Sari L Schechter, Loren S Coon, Devin |
| description | Purpose:
Transgender and gender-diverse (TGD) individuals in the United States face disproportionate barriers to health care access. This study compared characteristics of individuals who have and have not undergone gender-affirming surgery with the goal of identifying social and systemic barriers to transition-related surgery.
Methods:
Data were extracted from the 2015 United States Transgender Survey, a cross-sectional nonprobability sample of nearly 28,000 TGD adults. The primary outcome was having undergone gender-affirming surgery. Multivariable logistic regression models were constructed to determine correlates of receipt of gender-affirming surgery. A subgroup analysis was performed to explore differences by insurance types regarding coverage of surgical procedures and presence of in-network providers.
Results:
In total, 6009 (21.7%) participants underwent transition-related procedures. Increased odds of undergoing surgery were associated with older age, living in congruent gender, higher education attainment, and greater income. Decreased odds were linked with male sex assignment at birth, first recognizing TGD status at older ages, living in states without trans-protective health laws, no close transgender-knowledgeable health care provider, nonbinary status, and identifying as sexual minority. Residing in states without trans-protective health laws correlated with increased surgery denials over the previous 12-month period. Compared to White TGD individuals, TGD individuals who were Black, Latinx, or Another Race were significantly more likely to encounter health equity-related barriers to surgery.
Conclusions:
Gender-affirming surgery access is differentially distributed across demographic and modifiable equity-related factors amenable to interventions. Efforts are needed to address the number and geographic distribution of transgender health-competent providers, improve TGD legal protections, and increase access to health insurance for minority TGD individuals, who are disproportionately under/uninsured. |
| doi_str_mv | 10.1089/lgbt.2023.0341 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_3065981072</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3065981072</sourcerecordid><originalsourceid>FETCH-LOGICAL-c295t-3b5e85fa482b292e545ad0df31deb14eb45d715880dc5afbf91fafdfe9a665a23</originalsourceid><addsrcrecordid>eNqFkLtPwzAQhy0EohV0ZUQZWRL8iFtnLBUvqRKIltk49rkyyqPYydD_HkdpWbnlTqfvfjp9CN0QnBEsivtqV3YZxZRlmOXkDE0pozwVDM_PTzMt6ATNQvjGsYqcML64RBMmRC5ovpiir02rnaoS1Zhkcwgd1E4nD8p7Bz4kXZtsvWqC61zbpB9QqQ4i1_ud0_Ho3bcaTO8hJLb1I7qDxoBPljX4yDThGl1YVQWYHfsV-nx63K5e0vXb8-tquU41LXiXspKD4FbFt8r4M_CcK4ONZcRASXIoc24WhAuBjebKlrYgVlljoVDzOVeUXaG7MXfv258eQidrFzRUlWqg7YOMUnghCF4MaDai2rcheLBy712t_EESLAexchArB7FyEBsPbo_ZfVmD-cNPGiOQj8CwVk1TOSjBd__l_gJb0YeD</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3065981072</pqid></control><display><type>article</type><title>Social and Systemic Barriers to Transition-Related Surgical Procedures for Transgender Americans</title><source>MEDLINE</source><source>Alma/SFX Local Collection</source><creator>Marano, Andrew A ; Miller, Amitai S ; Castillo, Wendy ; Reisner, Sari L ; Schechter, Loren S ; Coon, Devin</creator><creatorcontrib>Marano, Andrew A ; Miller, Amitai S ; Castillo, Wendy ; Reisner, Sari L ; Schechter, Loren S ; Coon, Devin</creatorcontrib><description>Purpose:
Transgender and gender-diverse (TGD) individuals in the United States face disproportionate barriers to health care access. This study compared characteristics of individuals who have and have not undergone gender-affirming surgery with the goal of identifying social and systemic barriers to transition-related surgery.
Methods:
Data were extracted from the 2015 United States Transgender Survey, a cross-sectional nonprobability sample of nearly 28,000 TGD adults. The primary outcome was having undergone gender-affirming surgery. Multivariable logistic regression models were constructed to determine correlates of receipt of gender-affirming surgery. A subgroup analysis was performed to explore differences by insurance types regarding coverage of surgical procedures and presence of in-network providers.
Results:
In total, 6009 (21.7%) participants underwent transition-related procedures. Increased odds of undergoing surgery were associated with older age, living in congruent gender, higher education attainment, and greater income. Decreased odds were linked with male sex assignment at birth, first recognizing TGD status at older ages, living in states without trans-protective health laws, no close transgender-knowledgeable health care provider, nonbinary status, and identifying as sexual minority. Residing in states without trans-protective health laws correlated with increased surgery denials over the previous 12-month period. Compared to White TGD individuals, TGD individuals who were Black, Latinx, or Another Race were significantly more likely to encounter health equity-related barriers to surgery.
Conclusions:
Gender-affirming surgery access is differentially distributed across demographic and modifiable equity-related factors amenable to interventions. Efforts are needed to address the number and geographic distribution of transgender health-competent providers, improve TGD legal protections, and increase access to health insurance for minority TGD individuals, who are disproportionately under/uninsured.</description><identifier>ISSN: 2325-8292</identifier><identifier>ISSN: 2325-8306</identifier><identifier>EISSN: 2325-8306</identifier><identifier>DOI: 10.1089/lgbt.2023.0341</identifier><identifier>PMID: 38848247</identifier><language>eng</language><publisher>United States: Mary Ann Liebert, Inc., publishers</publisher><subject>Adolescent ; Adult ; Cross-Sectional Studies ; Female ; Health Services Accessibility - statistics & numerical data ; Healthcare Disparities ; Humans ; Male ; Middle Aged ; Original Articles ; Sex Reassignment Surgery - legislation & jurisprudence ; Transgender Persons - psychology ; Transgender Persons - statistics & numerical data ; United States ; Young Adult</subject><ispartof>LGBT health, 2024-12, Vol.11 (8), p.615-624</ispartof><rights>2024, Mary Ann Liebert, Inc., publishers</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c295t-3b5e85fa482b292e545ad0df31deb14eb45d715880dc5afbf91fafdfe9a665a23</cites><orcidid>0000-0001-6130-6810 ; 0000-0001-7868-4746 ; 0000-0001-8458-9710</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38848247$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Marano, Andrew A</creatorcontrib><creatorcontrib>Miller, Amitai S</creatorcontrib><creatorcontrib>Castillo, Wendy</creatorcontrib><creatorcontrib>Reisner, Sari L</creatorcontrib><creatorcontrib>Schechter, Loren S</creatorcontrib><creatorcontrib>Coon, Devin</creatorcontrib><title>Social and Systemic Barriers to Transition-Related Surgical Procedures for Transgender Americans</title><title>LGBT health</title><addtitle>LGBT Health</addtitle><description>Purpose:
Transgender and gender-diverse (TGD) individuals in the United States face disproportionate barriers to health care access. This study compared characteristics of individuals who have and have not undergone gender-affirming surgery with the goal of identifying social and systemic barriers to transition-related surgery.
Methods:
Data were extracted from the 2015 United States Transgender Survey, a cross-sectional nonprobability sample of nearly 28,000 TGD adults. The primary outcome was having undergone gender-affirming surgery. Multivariable logistic regression models were constructed to determine correlates of receipt of gender-affirming surgery. A subgroup analysis was performed to explore differences by insurance types regarding coverage of surgical procedures and presence of in-network providers.
Results:
In total, 6009 (21.7%) participants underwent transition-related procedures. Increased odds of undergoing surgery were associated with older age, living in congruent gender, higher education attainment, and greater income. Decreased odds were linked with male sex assignment at birth, first recognizing TGD status at older ages, living in states without trans-protective health laws, no close transgender-knowledgeable health care provider, nonbinary status, and identifying as sexual minority. Residing in states without trans-protective health laws correlated with increased surgery denials over the previous 12-month period. Compared to White TGD individuals, TGD individuals who were Black, Latinx, or Another Race were significantly more likely to encounter health equity-related barriers to surgery.
Conclusions:
Gender-affirming surgery access is differentially distributed across demographic and modifiable equity-related factors amenable to interventions. Efforts are needed to address the number and geographic distribution of transgender health-competent providers, improve TGD legal protections, and increase access to health insurance for minority TGD individuals, who are disproportionately under/uninsured.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Cross-Sectional Studies</subject><subject>Female</subject><subject>Health Services Accessibility - statistics & numerical data</subject><subject>Healthcare Disparities</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Original Articles</subject><subject>Sex Reassignment Surgery - legislation & jurisprudence</subject><subject>Transgender Persons - psychology</subject><subject>Transgender Persons - statistics & numerical data</subject><subject>United States</subject><subject>Young Adult</subject><issn>2325-8292</issn><issn>2325-8306</issn><issn>2325-8306</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkLtPwzAQhy0EohV0ZUQZWRL8iFtnLBUvqRKIltk49rkyyqPYydD_HkdpWbnlTqfvfjp9CN0QnBEsivtqV3YZxZRlmOXkDE0pozwVDM_PTzMt6ATNQvjGsYqcML64RBMmRC5ovpiir02rnaoS1Zhkcwgd1E4nD8p7Bz4kXZtsvWqC61zbpB9QqQ4i1_ud0_Ho3bcaTO8hJLb1I7qDxoBPljX4yDThGl1YVQWYHfsV-nx63K5e0vXb8-tquU41LXiXspKD4FbFt8r4M_CcK4ONZcRASXIoc24WhAuBjebKlrYgVlljoVDzOVeUXaG7MXfv258eQidrFzRUlWqg7YOMUnghCF4MaDai2rcheLBy712t_EESLAexchArB7FyEBsPbo_ZfVmD-cNPGiOQj8CwVk1TOSjBd__l_gJb0YeD</recordid><startdate>20241201</startdate><enddate>20241201</enddate><creator>Marano, Andrew A</creator><creator>Miller, Amitai S</creator><creator>Castillo, Wendy</creator><creator>Reisner, Sari L</creator><creator>Schechter, Loren S</creator><creator>Coon, Devin</creator><general>Mary Ann Liebert, Inc., publishers</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-6130-6810</orcidid><orcidid>https://orcid.org/0000-0001-7868-4746</orcidid><orcidid>https://orcid.org/0000-0001-8458-9710</orcidid></search><sort><creationdate>20241201</creationdate><title>Social and Systemic Barriers to Transition-Related Surgical Procedures for Transgender Americans</title><author>Marano, Andrew A ; Miller, Amitai S ; Castillo, Wendy ; Reisner, Sari L ; Schechter, Loren S ; Coon, Devin</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c295t-3b5e85fa482b292e545ad0df31deb14eb45d715880dc5afbf91fafdfe9a665a23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Cross-Sectional Studies</topic><topic>Female</topic><topic>Health Services Accessibility - statistics & numerical data</topic><topic>Healthcare Disparities</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Original Articles</topic><topic>Sex Reassignment Surgery - legislation & jurisprudence</topic><topic>Transgender Persons - psychology</topic><topic>Transgender Persons - statistics & numerical data</topic><topic>United States</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Marano, Andrew A</creatorcontrib><creatorcontrib>Miller, Amitai S</creatorcontrib><creatorcontrib>Castillo, Wendy</creatorcontrib><creatorcontrib>Reisner, Sari L</creatorcontrib><creatorcontrib>Schechter, Loren S</creatorcontrib><creatorcontrib>Coon, Devin</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>LGBT health</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Marano, Andrew A</au><au>Miller, Amitai S</au><au>Castillo, Wendy</au><au>Reisner, Sari L</au><au>Schechter, Loren S</au><au>Coon, Devin</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Social and Systemic Barriers to Transition-Related Surgical Procedures for Transgender Americans</atitle><jtitle>LGBT health</jtitle><addtitle>LGBT Health</addtitle><date>2024-12-01</date><risdate>2024</risdate><volume>11</volume><issue>8</issue><spage>615</spage><epage>624</epage><pages>615-624</pages><issn>2325-8292</issn><issn>2325-8306</issn><eissn>2325-8306</eissn><abstract>Purpose:
Transgender and gender-diverse (TGD) individuals in the United States face disproportionate barriers to health care access. This study compared characteristics of individuals who have and have not undergone gender-affirming surgery with the goal of identifying social and systemic barriers to transition-related surgery.
Methods:
Data were extracted from the 2015 United States Transgender Survey, a cross-sectional nonprobability sample of nearly 28,000 TGD adults. The primary outcome was having undergone gender-affirming surgery. Multivariable logistic regression models were constructed to determine correlates of receipt of gender-affirming surgery. A subgroup analysis was performed to explore differences by insurance types regarding coverage of surgical procedures and presence of in-network providers.
Results:
In total, 6009 (21.7%) participants underwent transition-related procedures. Increased odds of undergoing surgery were associated with older age, living in congruent gender, higher education attainment, and greater income. Decreased odds were linked with male sex assignment at birth, first recognizing TGD status at older ages, living in states without trans-protective health laws, no close transgender-knowledgeable health care provider, nonbinary status, and identifying as sexual minority. Residing in states without trans-protective health laws correlated with increased surgery denials over the previous 12-month period. Compared to White TGD individuals, TGD individuals who were Black, Latinx, or Another Race were significantly more likely to encounter health equity-related barriers to surgery.
Conclusions:
Gender-affirming surgery access is differentially distributed across demographic and modifiable equity-related factors amenable to interventions. Efforts are needed to address the number and geographic distribution of transgender health-competent providers, improve TGD legal protections, and increase access to health insurance for minority TGD individuals, who are disproportionately under/uninsured.</abstract><cop>United States</cop><pub>Mary Ann Liebert, Inc., publishers</pub><pmid>38848247</pmid><doi>10.1089/lgbt.2023.0341</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0001-6130-6810</orcidid><orcidid>https://orcid.org/0000-0001-7868-4746</orcidid><orcidid>https://orcid.org/0000-0001-8458-9710</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 2325-8292 |
| ispartof | LGBT health, 2024-12, Vol.11 (8), p.615-624 |
| issn | 2325-8292 2325-8306 2325-8306 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_3065981072 |
| source | MEDLINE; Alma/SFX Local Collection |
| subjects | Adolescent Adult Cross-Sectional Studies Female Health Services Accessibility - statistics & numerical data Healthcare Disparities Humans Male Middle Aged Original Articles Sex Reassignment Surgery - legislation & jurisprudence Transgender Persons - psychology Transgender Persons - statistics & numerical data United States Young Adult |
| title | Social and Systemic Barriers to Transition-Related Surgical Procedures for Transgender Americans |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-21T18%3A35%3A02IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Social%20and%20Systemic%20Barriers%20to%20Transition-Related%20Surgical%20Procedures%20for%20Transgender%20Americans&rft.jtitle=LGBT%20health&rft.au=Marano,%20Andrew%20A&rft.date=2024-12-01&rft.volume=11&rft.issue=8&rft.spage=615&rft.epage=624&rft.pages=615-624&rft.issn=2325-8292&rft.eissn=2325-8306&rft_id=info:doi/10.1089/lgbt.2023.0341&rft_dat=%3Cproquest_cross%3E3065981072%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=3065981072&rft_id=info:pmid/38848247&rfr_iscdi=true |