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Cited by 368LGBTQ Health, Identity, and PolicyAdolescent and Pediatric HealthcareHIV/AIDS Research and Interventions

Discrimination and Delayed Health Care Among Transgender Women and Men: Implications for Improving Medical Education and Health Care Delivery

Jaffee, Kim D., Shires, Deirdre A., Stroumsa, Daphna·2016·Medical Care
DOI 10.1097/mlr.0000000000000583
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Abstract

BACKGROUND: The transgender community experiences health care discrimination and approximately 1 in 4 transgender people were denied equal treatment in health care settings. Discrimination is one of the many factors significantly associated with health care utilization and delayed care. OBJECTIVES: We assessed factors associated with delayed medical care due to discrimination among transgender patients, and evaluated the relationship between perceived provider knowledge and delayed care using Anderson's behavioral model of health services utilization. RESEARCH DESIGN: Multivariable logistic regression analysis was used to test whether predisposing, enabling, and health system factors were associated with delaying needed care for transgender women and transgender men. SUBJECTS: A sample of 3486 transgender participants who took part in the National Transgender Discrimination Survey in 2008 and 2009. MEASURES: Predisposing, enabling, and health system environment factors, and delayed needed health care. RESULTS: Overall, 30.8% of transgender participants delayed or did not seek needed health care due to discrimination. Respondents who had to teach health care providers about transgender people were 4 times more likely to delay needed health care due to discrimination. CONCLUSIONS: Transgender patients who need to teach their providers about transgender people are significantly more likely to postpone or not seek needed care. Systemic changes in provider education and training, along with health care system adaptations to ensure appropriate, safe, and respectful care, are necessary to close the knowledge and treatment gaps and prevent delayed care with its ensuing long-term health implications.

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Crossref · 10.1097/mlr.0000000000000583

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24 of 24 references verified0 citation errors · 0 not checkable

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  • Lack of medical provider knowledge and other barriers to care often result in transgender and gender nonbinary persons avoiding or delaying preventive care services and incurring missed opportunities for HIV and STI prevention services.

    “Lack of medical provider knowledge and other barriers to care (e.g., discrimination in health care settings or denial of services) often result in transgender and gender nonbinary persons avoiding or delaying preventive care services (338–340) and incurring missed opportunities for HIV and STI prevention services.”

    From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [339]

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Authors
Jaffee, K. D., Shires, D. A., & Stroumsa, D.
Affiliations
  • Wayne State University (US)
  • Henry Ford Hospital (US)
Corresponding author
  • Jaffee, Kim D.
  • Shires, Deirdre A.
ORCID
Venue
Medical Care
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2016-11
Volume
54
Issue
11
Pages
1010-1016
ISSN
0025-7079 (ISSN-L)
DOI
10.1097/mlr.0000000000000583
OpenAlex
W2431108700
Cited by
368
References
24
Citations by year
2026: 21 · 2025: 35 · 2024: 49 · 2023: 52 · 2022: 48 · 2021: 56 · 2020: 43 · 2019: 32 · 2018: 23 · 2017: 9
FWCI
33.54
Type
journal article
Language
en
Open access
closed
Locations
  • Medical Care (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 people, health care discrimination, delayed care, health care utilization, transgender health care, provider education and training, transgender women, transgender men
MeSH terms
Adolescent, Adult, Cross-Sectional Studies, Delivery of Health Care, Education, Medical, Female, Humans, Male, Middle Aged, Prejudice, United States, Healthcare Disparities, Young Adult, Quality Improvement, Transgender Persons

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