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

Stroumsa, Daphna; Crissman, Halley P.; Dalton, Vanessa K.; Kolenic, Giselle; Richardson, Caroline R.

doi:10.1370/afm.2586

Cited by 33 publications

(18 citation statements)

References 23 publications

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“…Insurance issues were a major contributor to variable dosing: specifically, a lack of insurance coverage, whether due to being uninsured or having health insurance that did not cover hormones, was highly associated with taking a reduced dose, potentially due to rationing or the inability to consistently afford the cost of their hormone prescription with no insurance coverage. A prior study found that uninsured trans people were less likely to be on any hormone treatment than insured trans people (Stroumsa et al, 2020). Even for people with insurance coverage, exclusions of gender-affirming care, including hormone therapy, persist among people with public insurance (particularly state Medicaid programs) and people with private insurance plans (Dowshen et al, 2019;Kirkland et al, 2021;Zaliznyak et al, 2021).…”

Section: Discussionmentioning

confidence: 99%

Gender affirming hormone therapy dosing behaviors among transgender and nonbinary adults

Restar

Dusic

Garrison-Desany

et al. 2022

Humanit Soc Sci Commun

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Gender-affirming hormones have been shown to improve psychological functioning and quality of life among transgender and nonbinary (trans) people, yet, scant research exists regarding whether and why individuals take more or less hormones than prescribed. Drawing on survey data from 379 trans people who were prescribed hormones, we utilized multivariable logistic regression models to identify factors associated with hormone-dosing behaviors and content analysis to examine the reasons for dose modifications. Overall, 24% of trans individuals took more hormones than prescribed and 57% took less. Taking more hormones than prescribed was significantly associated with having the same provider for primary and gender-affirming care and gender-based discrimination. Income and insurance coverage barriers were significantly associated with taking less hormones than prescribed. Differences by gender identity were also observed. Addressing barriers to hormone access and cost could help to ensure safe hormone-dosing behaviors and the achievement trans people’s gender-affirmation goals.

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Section: Discussionmentioning

confidence: 99%

Gender affirming hormone therapy dosing behaviors among transgender and nonbinary adults

Restar

Dusic

Garrison-Desany

et al. 2022

Humanit Soc Sci Commun

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“…To avoid insurance denials for imaging services, such as screening mammograms for transmasculine patients, some TGD patients are forced to mention only the gender assigned at birth on billing forms [19]. Matzanke et al developed a survey for TGNB patients to explore and evaluate their experiences during imaging encounters [20]. Of the 363 respondents who met the inclusion criteria, 257 (70.8%) reported having had at least one negative imaging encounter.…”

Section: Hormonal Therapymentioning

confidence: 99%

Journeying Through the Hurdles of Gender-Affirming Care Insurance: A Literature Analysis

Patel¹,

Camacho²,

Salehi³

et al. 2023

Cureus

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Gender-affirming surgery (GAS) has been proven to be successful in the treatment of gender dysphoria. The benefits of providing insurance coverage for transition-related surgeries far surpass the costs of suffering from persistent gender dysphoria, including many positive health outcomes such as decreased rates of substance use, psychiatric illness, and suicide. Despite being deemed a medical necessity, discrepancies in access to treatment and insurance coverage for GAS persist. The purpose of this review is to understand the impact of limited insurance coverage on the well-being of transgender patients. A comprehensive search was conducted utilizing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines in SCOPUS and PubMed databases using the terms "insurance" AND "gender affirming surgery." Articles in non-English languages were excluded. Data related to variations in insurance coverage for GAS in the United States were collected. Of the 67 articles reviewed, 29 met the inclusion criteria. When compared to the general population, individuals who identify as transgender have higher rates of being uninsured as of 2020, with only 30 states in the United States providing insurance coverage for transgender and gender nonbinary people. Of the 30 states, only 18 provide coverage for GAS, with chondrolaryngoplasty having the highest prevalence of coverage. As evidenced in our review, the persistence of complex insurance regulations impedes transgender individuals' access to equitable care. Overall, this literature review elucidates the variability in insurance coverage as it relates to gender-affirming care. Furthermore, this review highlights the need for additional health policy reforms, in addition to improving physician awareness regarding the hurdles of navigating the insurance world as a transgender patient.

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“…37 In addition, studies have demonstrated that an inability to access health care contributes to many transgender people using nonprescribed hormones from unlicensed sources, with rates of nonprescribed use ranging from 9.1% to 49%. 50,51 Gender-affirming Care Gender affirmation is a multifaceted process by which a person is recognized and feels supported in their gender identity, expression, and role. This process may include, but does not necessarily require, social gender role transition, legal change in name or pronoun, and medical and/or surgical treatments.…”

Section: Unique Health Care Needs Of Transgender and Gender Nonbinary...mentioning

confidence: 99%

“…In a survey of 35,000 LGBTQ youth in the United States, 48% reported that they sought mental health counseling but ultimately did not receive it 37. In addition, studies have demonstrated that an inability to access health care contributes to many transgender people using nonprescribed hormones from unlicensed sources, with rates of nonprescribed use ranging from 9.1% to 49% 50,51…”

Section: Unique Health Care Needs Of Transgender and Gender Nonbinary...mentioning

confidence: 99%

Management of Menstruation in Transgender and Gender Nonbinary Adolescents

Berrahou

Grimes

Autry

et al. 2022

Clinical Obstetrics &Amp; Gynecology

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A growing number of adolescents in the United States identify as transgender and gender nonbinary, and many will seek medical management of menstruation. In this evidence-based review, we recommend a model of gender-affirming care grounded in the tenants of reproductive justice, emphasizing patient autonomy and the development of holistic management plans centered around the patient’s unique goals for affirming their gender identity. We then review strategies for achieving menstruation suppression for transgender and gender nonbinary adolescents, including dosing considerations, menstruation, ovulation, contraceptive effects, and metabolic considerations specific to the adolescent population.

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

Cited by 33 publications

References 23 publications

Gender affirming hormone therapy dosing behaviors among transgender and nonbinary adults

Gender affirming hormone therapy dosing behaviors among transgender and nonbinary adults

Journeying Through the Hurdles of Gender-Affirming Care Insurance: A Literature Analysis

Management of Menstruation in Transgender and Gender Nonbinary Adolescents

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