• Am J Prev Med · Apr 2020

    Patterns of Healthcare Discrimination Among Transgender Help-Seekers.

    • Meghan Romanelli and Michael A Lindsey.
    • McSilver Institute for Poverty Policy and Research, Silver School of Social Work, New York University, New York, New York. Electronic address: mbr303@nyu.edu.
    • Am J Prev Med. 2020 Apr 1; 58 (4): e123-e131.

    IntroductionAffirmative health care is imperative to address health and mental health disparities faced by transgender communities. Yet, transgender help-seekers experience discrimination that precludes their access to and participation in care. This study uses latent class analysis to examine patterns of healthcare discrimination among transgender help-seekers. Predictors of class membership are investigated to identify subpopulations at highest risk for healthcare discrimination.MethodsData were obtained from the 2015 U.S. Transgender Survey and analyzed in 2019. Ten healthcare experiences were included as latent class indicators. Latent class analysis and regression were performed in Mplus, version 8 to identify latent subgroups and examine the relationship between respondent characteristics and the latent classes.ResultsThe final sample included 23,541 respondents. A 3-class model fit best: Class 1 experienced overt discrimination and interfaced with providers with limited trans-competence; Class 2 did not experience healthcare discrimination or report issues related to providers' trans-competence; and Class 3 did not experience discrimination but had providers with low trans-competence. Transmen and respondents who were out as trans to their providers and reported psychological distress, suicidal thoughts, and disabilities were more likely to be members of Class 1 or 3 than Class 2.ConclusionsExperiences of healthcare discrimination are not homogeneous across transgender help-seekers. Predictors of the latent classes indicated that transgender help-seekers holding an additional marginalized identity may be at higher risk for healthcare discrimination or care from providers with limited trans-competence. Targeted engagement and education interventions might improve these transgender help-seekers' access to and connections with care.Copyright © 2019 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

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