The Health and Well-Being of Transgender Australians: A National Community Survey

Abstract

Purpose: Transgender, including gender diverse and nonbinary (trans), people experience significant health disparities. We aimed to better understand the health status and needs of Australian trans people to guide resources and health and well-being programs. Methods: This anonymous, cross-sectional online survey utilized nonprobability snowball sampling of Australian adults (18 years and over) who self-identified as trans between September 2017 and January 2018. This descriptive study assessed demographic data, community views on access to health care, health burden, access to health resources, and priorities for government funding in transgender health. Results: Of 928 participants, 37% reported female, 36% reported male, and 27% reported nonbinary gender identities. Despite 47% having tertiary qualifications, the unemployment rate was 19%, with 33% reporting discrimination in employment due to being trans. Discrimination in accessing health care was reported by 26% and verbal abuse and physical assault were reported by 63% and 22%, respectively. Lifetime diagnosis of depression was reported by 73% and anxiety by 67%. Sixty-three percent reported previous self-harm and 43% had attempted suicide. Autism spectrum disorder and attention-deficit/hyperactivity disorder were reported by 15% and 11%, respectively. The most preferred method of receiving health information was through online resources, with the most popular source being Reddit, an online peer discussion board. Better training for doctors in trans health issues was the top priority for government funding. Conclusions: Barriers, including widespread discrimination and unemployment, contribute to health inequity and prevalent mental health conditions. Better training for health professionals in the provision of safe, genderaffirming and general health care for trans people is urgently required.

Feminizing Hormone Therapy Prescription Patterns and Cardiovascular Risk Factors in Aging Transgender Individuals in Australia

“…This is considerably higher than recent Australian population data highlighting a smoking prevalence of 16.9% in the general population in persons aged 45-54 years (males 19.3%, females 14.7%) (24). Smoking rates in trans individuals aged ≥45 in our study were also higher than a recent cross-sectional survey of Australian trans adults (current smoking 15%), noting that this survey reflected a younger demographic with a median age of 28 years (25).…”

Short-Term Effects of Gender-Affirming Hormone Therapy on Dysphoria and Quality of Life in Transgender Individuals: A Prospective Controlled Study

“…Transgender individuals (trans) experience a gender identity (which may be binary or non-binary) different from that which they were presumed at birth, and often, but not always, this gender incongruency is associated with significant psychological distress, known as gender dysphoria ( 1 , 2 ). Despite considerable progress made by the trans community over the past decade in regard to visibility and acceptance, trans people still face significant obstacles and prejudice ( 3 , 4 ), social stigma and discrimination, leading to job and housing insecurity, verbal and physical violence, and barriers to accessing appropriate healthcare ( 3 ). Similarly, trans people experience alarmingly high rates of mental health disorders compared to the general population ( 5 , 6 ).…”

“…Similarly, trans people experience alarmingly high rates of mental health disorders compared to the general population ( 5 , 6 ). A recent study looking at self-reported mental health diagnoses within the trans community has indicated that 73% of trans adults have been diagnosed with depression in their lifetime, 67% have been diagnosed with anxiety, and 43% attempted suicide in their lifetime ( 3 ). In contrast, self-reported rates of depression, anxiety and suicide attempts for the general population are indicated at 11.6%, 26.3%, and 3.2% respectively ( 7 ).…”

Towards Making an Invisible Diversity Visible: A Study of Socially Structured Barriers for Purple Collar Employees in the Workplace

“…Employees at work alienate themselves from transgender coworkers due to their personal characteristics [39]. Their personal attributes seem strange as these attributes do not align with either male or female attributes [40][41][42]. Employees maintain a distance as a result of the lack of the proper identity of transgender people and coworkers sometimes feel deficient in finding a suitable name or pronoun to address their transgender coworkers [39,40].…”