Satisfaction and healthcare utilization of transgender and gender non-conforming individuals in NYC: a community-based participatory study.
Abstract
PURPOSE: Transgender and gender non-conforming (TGNC) individuals face high levels of discrimination and mistreatment, including within social and medical service settings, which may lead to negative health and psychosocial sequelae. Given the many barriers to competent care, we sought to determine points of intervention by assessing the current needs, satisfaction, and health care utilization of TGNC individuals in New York City as reported by TGNC individuals. METHODS: In January 2013, fifty TGNC individuals were recruited via flyers and direct referrals from healthcare professionals within community spaces and pertinent venues. We administered a brief survey and conducted four focus groups exploring participants' health care utilization and perceived barriers to care, routine care, hormone and silicone use, and recommendations for improving transgender services. RESULTS: Participants were 18- to 64-years-old, racially/ethnically diverse, and the majority were medically insured, underwent routine health care in the last year, and received an HIV test in their lifetime. A significant proportion reported taking hormones prescribed by a medical provider and were in the care of knowledgeable providers. Participants perceived four areas where barriers persisted: utilization of preventive services, access to transition-related procedures, access to legal assistance, and inclusion of TGNC individuals in public health education and campaigns. CONCLUSIONS: Structural interventions are needed, such as comprehensive provider training programs for all level staff to better serve the needs of TGNC individuals, increase service utilization and improve wellbeing, while effecting lasting institutional change. Service provision establishments should hire more TGNC staff and integrate transgender care into existing practices.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Transgender persons often experience high rates of stigma and socioeconomic and structural barriers to care that negatively affect health care usage and increase susceptibility to HIV and STIs.
“Transgender persons often experience high rates of stigma and socioeconomic and structural barriers to care that negatively affect health care usage and increase susceptibility to HIV and STIs (326–332).”
From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [328]
Cites
(1998) · Sage eBooks · Cited by 38,631 · see citing works
(2002) · Cited by 13,211 · see citing works
Focus Groups as Qualitative Research
Morgan, D. (1997) · doi:10.4135/9781412984287 · Cited by 8,863 · see citing works
Coleman, E., Bockting, W. O., Botzer, M., Cohen‐Kettenis, P. T., Cuypere, G. D., Feldman, J., Fraser, L., Green, J., Knudson, G., Meyer, W. J., et al. (2012) · International Journal of Transgenderism · doi:10.1080/15532739.2011.700873 · Cited by 3,145 · see citing works
Worldwide burden of HIV in transgender women: a systematic review and meta-analysis.
Baral, S. D., Poteat, T., Strömdahl, S., Wirtz, A. L., Guadamuz, T. E., & Beyrer, C. (2013) · The Lancet Infectious Diseases · doi:10.1016/s1473-3099(12)70315-8 · Cited by 1,461 · see citing works
Doing Qualitative Research: Circles Within Circles
Anzul, M., Ely, M., Freidman, T., Garner, D., & McCormack-Steinmetz, A. (1991) · Medical Entomology and Zoology · Cited by 1,367 · see citing works
Lesbian, Gay, Bisexual, and Transgender–Related Content in Undergraduate Medical Education
Obedin‐Maliver, J., Goldsmith, E. S., Stewart, L. A., White, W., Tran, E., Brenman, S., Wells, M., Fetterman, D. M., García, G., & Lunn, M. R. (2011) · JAMA · doi:10.1001/jama.2011.1255 · Cited by 1,158 · see citing works
Syndemics and public health: Reconceptualizing disease in bio-social context
Singer, M., & Clair, S. (2003) · Medical Anthropology Quarterly · doi:10.1525/maq.2003.17.4.423 · Cited by 1,140 · see citing works
Stall, R., Mills, T. C., Williamson, J., Hart, T., Greenwood, G., Paul, J., Pollack, L., Binson, D., Osmond, D., & Catania, J. A. (2003) · American Journal of Public Health · doi:10.2105/ajph.93.6.939 · Cited by 940 · see citing works
Quinn, D. M., & Chaudoir, S. R. (2009) · Journal of Personality and Social Psychology · doi:10.1037/a0015815 · Cited by 934 · see citing works
for the HIV/AIDS Prevention Research Synthesis Team, Herbst, J. H., Jacobs, E. D., Finlayson, T. J., McKleroy, V. S., Neumann, M. S., & Crepaz, N. (2008) · AIDS and Behavior · doi:10.1007/s10461-007-9299-3 · Cited by 933 · see citing works
Bauer, G. R., Hammond, R., Travers, R., Kaay, M., Hohenadel, K., & Boyce, M. (2009) · Journal of the Association of Nurses in AIDS Care · doi:10.1016/j.jana.2009.07.004 · Cited by 930 · see citing works
Clements-Nolle, K. D., Marx, R., Guzman, R., & Katz, M. H. (2001) · American Journal of Public Health · doi:10.2105/ajph.91.6.915 · Cited by 776 · see citing works
Violence against transgender people: A review of United States data
Stotzer, R. L. (2009) · Aggression and Violent Behavior · doi:10.1016/j.avb.2009.01.006 · Cited by 701 · see citing works
Transgender Youth and Life‐Threatening Behaviors
Grossman, A. H., & D'Augelli, A. R. (2007) · Suicide and Life-Threatening Behavior · doi:10.1521/suli.2007.37.5.527 · Cited by 672 · see citing works
Dhejne, C., Lichtenstein, P., Boman, M., Johansson, A. L. V., Långström, N., & Landén, M. (2011) · PLoS ONE · doi:10.1371/journal.pone.0016885 · Cited by 619 · see citing works
Physical and Mental Health of Transgender Older Adults: An At-Risk and Underserved Population
Fredriksen-Goldsen, K. I., Cook-Daniels, L., Kim, H.-J., Erosheva, E. A., Emlet, C. A., Hoy-Ellis, C. P., Goldsen, J., & Muraco, A. (2014) · The Gerontologist · doi:10.1093/geront/gnt021 · Cited by 582 · see citing works
Garofalo, R., Deleon, J., Osmer, E., Doll, M., & Harper, G. W. (2006) · Journal of Adolescent Health · doi:10.1016/j.jadohealth.2005.03.023 · Cited by 538 · see citing works
Transgender Health: Findings from Two Needs Assessment Studies in Philadelphia
Kenagy, G. P. (2005) · Health & Social Work · doi:10.1093/hsw/30.1.19 · Cited by 503 · see citing works
Promoting Health: Intervention Strategies from Social and Behavioral Research
Smedley, B. D., & Sl, S. (2001) · American Journal of Health Promotion · doi:10.4278/0890-1171-15.3.149 · Cited by 465 · see citing works
Sánchez, N. F., Sánchez, J. P., & Danoff, A. (2009) · American Journal of Public Health · doi:10.2105/ajph.2007.132035 · Cited by 420 · see citing works
Fredriksen‐Goldsen, K. I., Kim, H., Emlet, C. A., Muraco, A., Erosheva, E. A., Hoy‐Ellis, C. P., Goldsen, J., & Petry, H. (2011) · PsycEXTRA Dataset · doi:10.1037/e561402013-001 · Cited by 395 · see citing works
A Two-Question Method for Assessing Gender Categories in the Social and Medical Sciences
Tate, C. C., Ledbetter, J. N., & Youssef, C. P. (2012) · The Journal of Sex Research · doi:10.1080/00224499.2012.690110 · Cited by 383 · see citing works
Singer, M. C., Erickson, P. I., Badiane, L., Diaz, R., Ortiz, D., Abraham, T., & Nicolaysen, A. M. (2006) · Social Science & Medicine · doi:10.1016/j.socscimed.2006.05.012 · Cited by 371 · see citing works
Snelgrove, J. W., Jasudavisius, A. M., Rowe, B. W., et al. (2012) · BMC Health Services Research · doi:10.1186/1472-6963-12-110 · Cited by 354 · see citing works
Effects of sex steroids on components of the insulin resistance syndrome in transsexual subjects
Elbers, J. M. H., Giltay, E. J., Teerlink, T., Scheffer, P. G., Asscheman, H., Seidell, J. C., & Gooren, L. J. (2003) · Clinical Endocrinology · doi:10.1046/j.1365-2265.2003.01753.x · Cited by 318 · see citing works
Golub, S. A., & Gamarel, K. E. (2013) · AIDS Patient Care and STDs · doi:10.1089/apc.2013.0245 · Cited by 314 · see citing works
Self-citationCultural Competence: A Systematic Review of Health Care Provider Educational Interventions
Beach, M., Price, E., Gary, T. L., Robinson, K. A., Gozu, A., Palacio, A., Smarth, C., Jenckes, M. W., Feuerstein, C., Bass, E. B., et al. (2005) · Medical Care · doi:10.1097/01.mlr.0000156861.58905.96 · Cited by 309 · see citing works
HIV Risk Behaviors Among Male-to-Female Transgender Persons of Color in San Francisco
Nemoto, T., Operario, D., Keatley, J. G., Han, L., & Soma, T. (2004) · American Journal of Public Health · doi:10.2105/ajph.94.7.1193 · Cited by 303 · see citing works
Enhancing transgender health care
Lombardi, E. L. (2001) · American Journal of Public Health · doi:10.2105/ajph.91.6.869 · Cited by 302 · see citing works
Deutsch, M. B., Green, J., Keatley, J., Mayer, G., Hastings, J., Hall, A. M., Deutsch, M. B., Keatley, J. G., Green, J., Allison, R., et al. (2013) · Journal of the American Medical Informatics Association · doi:10.1136/amiajnl-2012-001472 · Cited by 299 · see citing works
Transgender HIV prevention: A qualitative needs assessment
Bockting, W. O., Robinson, B. E., & Rosser, B. R. S. (1998) · AIDS Care · doi:10.1080/09540129850124028 · Cited by 285 · see citing works
Perceived Risks and Benefits of Sex Work among Transgender Women of Color in San Francisco
Sausa, L. A., Keatley, J. G., & Operario, D. (2007) · Archives of Sexual Behavior · doi:10.1007/s10508-007-9210-3 · Cited by 265 · see citing works
HIV in transgender communities: syndemic dynamics and a need for multicomponent interventions
Operario, D., & Nemoto, T. (2010) · JAIDS Journal of Acquired Immune Deficiency Syndromes · doi:10.1097/qai.0b013e3181fbc9ec · Cited by 224 · see citing works
Burdge, B. J. (2007) · Social Work · doi:10.1093/sw/52.3.243 · Cited by 203 · see citing works
Social context of HIV risk behaviours among male-to-female transgenders of colour
Nemoto, T., Operario, D., Keatley, J. G., & Villegas, D. (2004) · AIDS Care · doi:10.1080/09540120413331269567 · Cited by 199 · see citing works
Access to Health Care for Transgendered Persons: Results of a Needs Assessment in Boston
Sperber, J., Landers, S., & Lawrence, S. (2005) · International Journal of Transgenderism · doi:10.1300/j485v08n02_08 · Cited by 189 · see citing works
HIV Infection Risk Factors Among Male-to-Female Transgender Persons: A Review of the Literature
Santis, J. P. D. (2009) · Journal of the Association of Nurses in AIDS Care · doi:10.1016/j.jana.2009.06.005 · Cited by 167 · see citing works
‘It's really a hard life’: Love, gender and HIV risk among male‐to‐female transgender persons
Melendez, R. M., & Pinto, R. M. (2007) · Culture Health & Sexuality · doi:10.1080/13691050601065909 · Cited by 163 · see citing works
Caenegem, E. V., Taes, Y., Wierckx, K., Vandewalle, S., Toye, K. R. C., Kaufman, J., Schreiner, T., Haraldsen, I., & T'Sjoen, G. G. (2013) · Bone · doi:10.1016/j.bone.2013.01.039 · Cited by 130 · see citing works
Sevelius, J. M., Reznick, O. G., Hart, S. L., & Schwarcz, S. K. (2009) · AIDS Education and Prevention · doi:10.1521/aeap.2009.21.2.113 · Cited by 128 · see citing works
Evaluation of a sexual health approach to reducing HIV/STD risk in the transgender community
Bockting, W. O., Robinson, B. E., Forberg, J., & Scheltema, K. E. (2004) · AIDS Care · doi:10.1080/09540120412331299825 · Cited by 125 · see citing works
Suicide risk among transgender individuals
Maguen, S., & Shipherd, J. C. (2010) · Psychology and Sexuality · doi:10.1080/19419891003634430 · Cited by 122 · see citing works
HIV Prevalence and Associated Risk Behaviors in New York City’s House Ball Community
Murrill, C. S., Liu, K.-L., Guilin, V., Colón, E. R., Dean, L. A., Buckley, L. A., Sanchez, T., Finlayson, T., & Torian, L. V. (2008) · American Journal of Public Health · doi:10.2105/ajph.2006.108936 · Cited by 103 · see citing works
Kellogg, T. A., Clements-Nolle, K. D., Dilley, J., Katz, M. H., & McFarland, W. C. (2001) · JAIDS Journal of Acquired Immune Deficiency Syndromes · doi:10.1097/00126334-200112010-00012 · Cited by 102 · see citing works
Farías, M. S. D. R., Garcia, M. N., Reynaga, E., Romero, M., Vaulet, M. L. G., Fermepín, M. R., Toscano, M. F., Rey, J. A., Marone, R. O., Squiquera, L., et al. (2011) · International Journal of Infectious Diseases · doi:10.1016/j.ijid.2011.05.007 · Cited by 94 · see citing works
Sex, Drugs, Violence, and HIV Status Among Male-to-Female Transgender Persons in Houston, Texas
Risser, J., Shelton, A. J., McCurdy, S., Atkinson, J. S., Padgett, P. M., Useche, B., Thomas, B., & Williams, M. L. (2005) · International Journal of Transgenderism · doi:10.1300/j485v08n02_07 · Cited by 74 · see citing works
Khan, L. (2011) · PubMed · Cited by 64 · see citing works
Lombardi, E. L. (2010) · International Journal of Transgenderism · doi:10.1080/15532739.2010.544232 · Cited by 63 · see citing works
Theorizing transgender diversity: Towards a social model of health
Monro, S. (2000) · Sexual & Relationship Therapy · doi:10.1080/14681990050001547 · Cited by 49 · see citing works
HIV/AIDS Programming in the United States: Considerations Affecting Transgender Women and Girls
Sevelius, J. M., Keatley, J. G., & Gutierrez-Mock, L. (2011) · Women s Health Issues · doi:10.1016/j.whi.2011.08.001 · Cited by 48 · see citing works
Clements-Nolle, K. D., Guzman, R., & Harris, S. G. (2008) · Sexual Health · doi:10.1071/sh07045 · Cited by 48 · see citing works
Garofalo, R., Osmer, E., Sullivan, C., et al. (2007) · Journal of HIV/AIDS Prevention in Children & Youth · doi:10.1300/j499v07n02_06 · Cited by 46 · see citing works
Public Health and Trans-People: Barriers to Care and Strategies to Improve Treatment
Lombardi, E. L. (2007) · Springer eBooks · doi:10.1007/978-0-387-31334-4_26 · Cited by 26 · see citing works
Infecciones de transmisión sexual en personas transgénero y otras identidades sexuales
Toibaro, J., Ebensrtejin, J. E., Parlante, Á., Burgoa, P., Freyre, A., Romero, M., & Losso, M. H. (2009) · Medicina-buenos Aires · Cited by 21 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Sexually Transmitted Infections Treatment Guidelines, 2021
Workowski, K. A., Bachmann, L. H., Chan, P. A., Johnston, C. M., Muzny, C. A., Park, I., Reno, H., Zenilman, J. M., & Bolan, G. A. (2021) · MMWR. Recommendations and Reports · doi:10.15585/mmwr.rr7004a1 · Cited by 2,759 · see citing works
Pitasi, M. A., Kerani, R. P., Kohn, R., Murphy, R. D., Pathela, P., Schumacher, C. M., Tabidze, I., & Llata, E. (2019) · Sexually Transmitted Diseases · doi:10.1097/olq.0000000000000917 · Cited by 61 · see citing works
- Authors
- Radix, A. E., Lelutiu-Weinberger, C., & Gamarel, K. E.
- Affiliations
- Callen Lorde Community Health Center, New York, New York.
- Department of Psychology, Hunter College of the City University of New York, New York.
- City University of New York (US)
- Corresponding author
- Radix, Anita E.
- ORCID
- Gamarel, Kristi E.
- Venue
- LGBT Health
- Publisher
- SAGE Publications
- Published
- 2014-12
- Volume
- 1
- Issue
- 4
- Pages
- 302-308
- ISSN
- 2325-8292 (ISSN-L)
- 2325-8306
- OpenAlex
- W1145809602
- Cited by
- 66
- References
- 55
- Citations by year
- 2025: 2 · 2024: 7 · 2023: 6 · 2022: 6 · 2021: 11 · 2020: 9 · 2019: 9 · 2018: 6 · 2017: 3 · 2016: 7
- FWCI
- 4.95
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- LGBT Health (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Social Psychology › LGBTQ Health, Identity, and Policy
- Health Sciences › Health Professions › Speech and Hearing › Adolescent and Pediatric Healthcare
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
- Keywords
- transgender health, gender non-conforming people, health care utilization, patient satisfaction, barriers to care, hormone therapy, silicone implants, preventive medicine, gender-affirming surgery, legal aid, public health education, provider training, health care discrimination, New York City
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
