Barriers to insurance coverage for transgender patients

Learmonth, Claire; Viloria, Rebekah; Lambert, Cei; Goldhammer, Hilary; Keuroghlian, Alex S.

doi:10.1016/j.ajog.2018.04.046

Cited by 52 publications

(32 citation statements)

References 11 publications

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“…TGNC communities have been subjected to a lack of competent and gender-affirmative routine, emergency, and transition-related care, and these negative experiences have been associated with higher rates of coping-based alcohol, cigarette, and substance use (Grant et al, 2011; Reisner et al, 2014). In some instances, marginalization of TGNC persons in medical settings may be institutionalized, as in the denial of some medical coverages for TGNC individuals not only for gender transition procedures but also for routine medical care in some instances (e.g., if an individual is able to transition from female to male on medical documentation but still requires a routine pap smear, or if an individual transitions legally from male to female and still requires prostate exams; Learmonth et al, in press; Stroumsa, 2014).…”

Section: Work Healthcare and Other Public Settingsmentioning

confidence: 99%

Stress and substance use among sexual and gender minority individuals across the lifespan

Parent¹,

Arriaga²,

Gobble³

et al. 2019

Neurobiology of Stress

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Sexual and gender minority (SGM) individuals face marked disparities in substance use. The present narrative review explores research on substance use in SGM communities using a minority stress theory lens. We define the SGM population and minority stress, and explore stresses and substance use disparities in adolescence, adulthood, and older age. Though research on this topic is beginning to highlight the relationship between stress and substance use for SGM individuals, more work is needed on older SGM populations and in translating research findings to effective interventions.

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Section: Work Healthcare and Other Public Settingsmentioning

confidence: 99%

Stress and substance use among sexual and gender minority individuals across the lifespan

Parent¹,

Arriaga²,

Gobble³

et al. 2019

Neurobiology of Stress

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show abstract

“…1,[16][17][18][19][20] With respect to health care experiences, LGBTQ populations have reported lower satisfaction with cancer care treatment 21,22 and higher rates of psychological distress in survivorship, 22 are less likely to have insurance coverage, 23,24 and report higher rates of perceived discrimination in the health care setting. [25][26][27] The cumulative evidence suggesting increased cancer risk and poorer outcomes among the LGBTQ community has direct translation implications. Specifically, providers with increased knowledge and understanding of the LGBTQ community will enable delivery of precision health care for primary, secondary, and tertiary preventions.…”

Section: Introductionmentioning

confidence: 99%

National Survey of Oncologists at National Cancer Institute–Designated Comprehensive Cancer Centers: Attitudes, Knowledge, and Practice Behaviors About LGBTQ Patients With Cancer

Schabath

Blackburn

Sutter

et al. 2019

JCO

106

118

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PURPOSE To identify potential gaps in attitudes, knowledge, and institutional practices toward lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) patients, a national survey of oncologists at National Cancer Institute–Designated Comprehensive Cancer Centers was conducted to measure these attributes related to LGBTQ patients and desire for future training and education. METHODS A random sample of 450 oncologists from 45 cancer centers was selected from the American Medical Association’s Physician Masterfile to complete a survey measuring attitudes and knowledge about LGBTQ health and institutional practices. Results were quantified using descriptive and stratified analyses and by a novel attitude summary measure. RESULTS Of the 149 respondents, there was high agreement (65.8%) regarding the importance of knowing the gender identity of patients, which was contrasted by low agreement (39.6%) regarding the importance of knowing sexual orientation. There was high interest in receiving education regarding the unique health needs of LGBTQ patients (70.4%), and knowledge questions yielded high percentages of “neutral” and “do not know or prefer not to answer” responses. After completing the survey, there was a significant decrease ( P < .001) in confidence in knowledge of health needs for LGB (53.1% agreed they were confident during survey assessment v 38.9% postsurvey) and transgender patients (36.9% v 19.5% postsurvey). Stratified analyses revealed some but limited influence on attitudes and knowledge by having LGBTQ friends and/or family members, political affiliation, oncology specialty, years since graduation, and respondents’ region of the country. CONCLUSION This was the first nationwide study, to our knowledge, of oncologists assessing attitudes, knowledge, and institutional practices of LGBTQ patients with cancer. Overall, there was limited knowledge about LGBTQ health and cancer needs but a high interest in receiving education regarding this community.

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“…19 Those who are insured often encounter insurance policies with specific exclusions or barriers for coverage of gender-affirming therapy. 4,[20][21][22] The Patient Protection and Affordable Care Act increased coverage specifically for transgender people by prohibiting exclusions based on preexisting conditions 23 and through the nondiscrimination clause in section 1557; however, these and other regulatory and legislative changes are in constant flux, vary by state and insurance carrier, and have not eliminated the gaps in insurance coverage for genderaffirming care. The barriers to insurance coverage combine with the other structural barriers to care to limit access to gender-affirming hormones.…”

mentioning

confidence: 99%

Insurance Coverage and Use of Hormones Among Transgender Respondents to a National Survey

et al. 2020

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Barriers to insurance coverage for transgender patients

Cited by 52 publications

References 11 publications

Stress and substance use among sexual and gender minority individuals across the lifespan

Stress and substance use among sexual and gender minority individuals across the lifespan

National Survey of Oncologists at National Cancer Institute–Designated Comprehensive Cancer Centers: Attitudes, Knowledge, and Practice Behaviors About LGBTQ Patients With Cancer

Insurance Coverage and Use of Hormones Among Transgender Respondents to a National Survey

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