Transgender Health Care in the U.S. Military and Veterans Health Administration Facilities

Kauth, Michael R.; Blosnich, John R.; Marra, Janelle; Keig, Zander; Shipherd, Jillian C.

doi:10.1007/s11930-017-0120-7

Cited by 9 publications

(10 citation statements)

References 26 publications

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“…Prior studies have found race to have an association with housing instability. For example, a study found higher rates of housing instability among black trans women compared to their white trans peers [3,41]. Prior studies found housing instability to be associated with social stigmatization for being transgender, but we did not identify literature showing associations between housing instability and intersectional, or combined anti-trans and racial discrimination [8,13].…”

Section: Discussionmentioning

confidence: 87%

“…Trans women have a higher likelihood of unmet basic needs than the general population, such as inadequate food and housing, which have in turn been associated with poor health outcomes [1,2,3]. A study in Los Angeles ( n = 517) that analyzed the relationship between hormone use and structural inequities (income, housing, and health insurance) among trans women found that more than half of study participants were unstably housed, 22.4% were marginally housed, and 34.8% were homeless [4].…”

Section: Introductionmentioning

confidence: 99%

“…Housing instability is associated with poor health outcomes among trans people [3]. Unstable housing is associated with depression, higher risk for HIV acquisition, low antiretroviral therapy (ART) adherence, and viral suppression, and substance use for trans women [1,4,6,8,9,10,11,12,13,14].…”

Section: Introductionmentioning

confidence: 99%

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Intersectional Discrimination Is Associated with Housing Instability among Trans Women Living in the San Francisco Bay Area

Beltran

Allen

Lin

et al. 2019

IJERPH

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Trans women face numerous structural barriers to health due to discrimination. Housing instability is an important structural determinant of poor health outcomes among trans women. The purpose of this study was to determine if experiences of intersectional anti-trans and racial discrimination are associated with poor housing outcomes among trans women in the San Francisco Bay Area. A secondary analysis of baseline data from the Trans *National study (n = 629) at the San Francisco Department of Public Health (2016–2018) was conducted. Multivariable logistic regression was used to analyze the association between discrimination as an ordered categorical variable (zero, one to two, or three or more experiences) and housing status adjusting for age, years lived in the Bay Area, and gender identity. We found that the odds of housing instability increased by 1.25 for every categorical unit increase (1–2, or 3+) in reported experiences of intersectional (both anti-trans and racial) discrimination for trans women (95% CI = 1.01–1.54, p-value < 0.05). Intersectional anti-trans and racial discrimination is associated with increased housing instability among trans women, giving some insight that policies and programs are needed to identify and address racism and anti-trans stigma towards trans women. Efforts to address intersectional discrimination may positively impact housing stability, with potential for ancillary effects on increasing the health and wellness of trans women who face multiple disparities.

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Section: Discussionmentioning

confidence: 87%

Section: Introductionmentioning

confidence: 99%

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Intersectional Discrimination Is Associated with Housing Instability among Trans Women Living in the San Francisco Bay Area

Beltran

Allen

Lin

et al. 2019

IJERPH

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“…For those who are no longer serving, higher rates of utilization may relate to the rapidly expanding availability of VHA services over the past decade for veterans who identify as TGD (31). Veterans who identify as TGD have reported being treated respectfully by VHA providers and have described being highly satisfied with their care (27,32).…”

Section: Discussionmentioning

confidence: 99%

Health Insurance and Mental Health Care Utilization Among Adults Who Identify as Transgender and Gender Diverse

Carter

Cowan

Snow

et al. 2020

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Transgender people are less likely to have health insurance, which has been associated with reduced utilization of health care. In the current study, the authors sought to assess the role of health insurance in mental health care utilization among transgender individuals.Methods: A total of 4,334 adults who self-identified as transgender or gender diverse (neither male nor female) participated in the 2017 Trans Lifeline Mental Health Survey, which included self-report measures of current insurance type and lifetime history of having seen a therapist or psychiatric provider. Logistic regression analyses assessed the association of insurance status with lifetime utilization of a mental health therapist or psychiatric provider.Results: Although only 8% of the sample were uninsured, these individuals were significantly less likely to have seen a therapist or psychiatric provider in their lifetime compared with those with health insurance, even after the analyses were adjusted for sociodemographic factors. Conversely, those with insurance through the military or the Veterans Health Administration were more than twice as likely as those with employer-provided insurance to have seen a therapist or psychiatric provider. There were no significant differences in mental health care utilization between those with employer-provided insurance versus public or privately purchased insurance.Conclusions: Rates of being uninsured were lower than in earlier assessments of transgender adults and adults who identify as gender diverse. However, type of health insurance also appeared to be a notable structural factor contributing to disparities in mental health care utilization among transgender individuals.

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“…There are currently 134,300 transgender veterans and an estimated 15,000 transgender Americans in active military service [43], so appropriate transgender care is especially critical for these populations [35,36,[42][43][44].…”

Section: Barriers To Gender-affirming Surgerymentioning

confidence: 99%

Exclusion of Medically Necessary Gender-Affirming Surgery for America's Armed Services Veterans

Kuzon¹,

Sluiter

Gast

2018

AMA Journal of Ethics

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Transgender Health Care in the U.S. Military and Veterans Health Administration Facilities

Cited by 9 publications

References 26 publications

Intersectional Discrimination Is Associated with Housing Instability among Trans Women Living in the San Francisco Bay Area

Intersectional Discrimination Is Associated with Housing Instability among Trans Women Living in the San Francisco Bay Area

Health Insurance and Mental Health Care Utilization Among Adults Who Identify as Transgender and Gender Diverse

Exclusion of Medically Necessary Gender-Affirming Surgery for America's Armed Services Veterans

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