Barriers to healthcare for transgender individuals

Abstract

Purpose of Review-Transgender persons suffer significant health disparities and may require medical intervention as part of their care. The purpose of this manuscript is to briefly review the literature characterizing barriers to health care for transgender individuals and to propose research priorities to understand mechanisms of those barriers and interventions to overcome them.Recent Findings-Current research emphasizes sexual minorities' self report of barriers, rather than using direct methods. The biggest barrier to health care reported by transgender individuals is lack of access due to lack of providers who are sufficiently knowledgeable on the topic. Other barriers include: financial barriers, discrimination, lack of cultural competence by providers, health systems barriers and socioeconomic barriers.Summary-National research priorities should include rigorous determination of the capacity of the United States health care system to provide adequate care for transgender individuals. Studies should determine knowledge and biases of the medical work force across the spectrum of medical training with regard to transgender medical care; adequacy of sufficient providers for the care

Barriers and Facilitators to Oral PrEP Use Among Transgender Women in New York City

“…A study of transgender women’s participation in HIV vaccine research reported that ensuring all clinical trials personnel receive transgender cultural competency training, creating trans-friendly environments, developing true partnerships with trans-friendly organizations and providers, providing transgender women participants with trials materials that address trans-specific concerns (e.g., hormones), and collecting/tracking data on trans-specific issues (e.g., hormone levels) could have positive implications for enrollment, retention, and adherence (39). Specifically, these changes may help transgender women to overcome issues that provoke discomfort and/or disengagement in healthcare settings, including mistrust of the medical community, absence of trans-friendly care providers with an adequate understanding of transgender medicine, and conscious or unconscious transphobia among clinic staff/providers (7, 11, 39). …”

“…This is an issue for several reasons. First, transgender women’s healthcare needs, HIV risk profile, and barriers to HIV prevention and treatment are distinct from gay and bisexual men (9–11). Therefore, transgender women are highly likely to have different challenges related to biomedical HIV prevention product use than these men, making extrapolation from gay and bisexual men-only studies inappropriate (7, 12–14).…”

An Exploratory Study of Transgender New Yorkers' Use of Sexual Health Services and Interest in Receiving Services at Planned Parenthood of New York City

“…4,8 Respondents to the NTDS were less likely to have insurance coverage than the general population, and were more likely to be covered by a public insurance plan. Fifty percent of respondents to the same survey stated that they had delayed receiving necessary healthcare because of inability to afford it.…”

Utilization of the Veterans Affairs’ Transgender E-consultation Program by Health Care Providers: Mixed-Methods Study (Preprint)

“…In a sample of nearly 250 3 rd and 4 th year medical students, only 56% chose the correct definition of the term "transgender" [31]. Unsurprisingly, some of the most oft-cited barriers to accessing care among transgender patients are the lack of knowledgeable providers (e.g., regarding transgender patients [i.e., body, identity, expression] and transgender-specific care) [15,32,33], or the patient having to educate the provider [4], which may be magnified for patients in rural and remote locations [22,34].…”

“…Expanding provider knowledge about transgender patients' needs can reduce misconceptions and stigma and facilitate high quality care provision [1,15]. The VA has improved transgender health care by becoming the first and largest US health care system to design and implement a national e-consultation program for transgender health care to "respond to specific inquiries on a case-by-case basis" [10].…”