Assessment of Health Conditions and Health Service Use Among Transgender Patients in Canada

Abstract

Key Points Question How do sociodemographic characteristics, chronic conditions, and health service utilization trajectories differ among transgender individuals compared with the general population? Findings This cross-sectional study identified and linked health administrative data for 2085 transgender individuals in Ontario, Canada, and found that transgender individuals are more likely to live in lower-income neighborhoods, experience chronic health conditions, and have higher health service use than the general population. Meaning This study demonstrates the need to improve the capacity to identify transgender individuals in administrative health data to understand the factors underlying their high rates of disease burden.

Gender Minority Stress, Psychiatric Comorbidities, and the Experience of Migraine in Transgender and Gender-Diverse Individuals: a Narrative Review

“…However, there seems to be a fair degree of heterogeneity between these studies. For instance, one study reported psychiatric comorbidities in 45.8% of a group of transgender children and adolescents [36] while another reported 53.2% of patients with gender dysphoria had at least one psychiatric disorder [37•], a third reported 76.3% of transgender individuals had psychiatric comorbidities [38], and a fourth reported 67.6% of a group of adolescents with gender dysphoria had no co-occurring psychiatric disorders [39].…”

Usability of Virtual Visits for the Routine Clinical Care of Trans Youth during the COVID-19 Pandemic: Youth and Caregiver Perspectives

“…Transgender people have been shown to have worse general and mental health outcomes than their cisgender counterparts. The reasons for this include stigma, discrimination, minority stress, and socioeconomic differences, among others [37][38][39][40]. The current global pandemic has accentuated health disparities among trans youth and other marginalized identities [18,19].…”

Characteristics of Transgender Individuals With Emergency Department Visits and Hospitalizations for Mental Health

“…Health administrative data can be useful to examine patterns of mental health care access for populations. Recent studies have explored transgender patients' use of mental health care by using health administrative data in the United States and Canada (12)(13)(14)(15)(16). Studies have found that transgender individuals were more likely to have had psychiatric outpatient visits, hospitalizations, and ED visits (12)(13)(14)(15)(16) than were cisgender people.…”

“…Individuals' Ontario health insurance number and date of birth were used to link individuals to administrative databases at ICES. This process has been previously described (16). All transgender individuals were identified from the study population and included in the two transgender samples in this study.…”

“…The following sociodemographic variables were measured for each group: age, LHIN, rurality (derived from postal code), neighborhood-level income (measured in quintiles at the census tract level), and ON-Marg quintiles. Gender identity was not included because of the high proportion of records with unknown gender in the transgender sample (16). The clinical diagnosis for the ED visit or hospitalization was captured in one of seven psychiatric diagnostic categories used in previous studies (19).…”