One size does not fit all: differential transgender health experiences

Kattari, Shanna K.; Atteberry‐Ash, Brittanie; Kinney, M. Killian; Walls, N. Eugene; Kattari, Leonardo

doi:10.1080/00981389.2019.1677279

Cited by 53 publications

(53 citation statements)

References 47 publications

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“…These findings follow extant research that found in-group differences within the TGD population in mental health (Kattari et al 2020), forced sex (Atteberry-Ash et al 2020), intimate partner violence (Walls et al 2019), and access to health care (Kattari et al 2019). Collectively, this demonstrates the need for surveys and forms to move away from the "man/woman/transgender" model that is so common and toward ones that allow for more nuance both within and across gender.…”

Section: Discussionsupporting

confidence: 84%

Increased Prevalence, Predictors, and In-Group Differences of Forced Sex and Physical Dating Violence among Trans/Gender Diverse Youth

et al. 2021

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Forced sex and dating violence are too common among young people and rates are higher for young transgender and gender diverse (TGD) individuals. However, the TGD youth population has differential experiences across gender, race, age, sexual orientation, and other identity factors. This study, using data from the 2015 Healthy Kids Colorado Survey, explores these differential within-group experiences of forced sex and dating violence. Findings indicate that sexual minorities who are also TGD are 2.45–3.73 times more likely to experience forced sex and physical dating violence than their TGD heterosexual peers. Individuals who are transfeminine (4.49 times), transmasculine (2.52 times), and nonbinary (3.86 times) are more likely to experience forced sex, as well as physical dating violence (transfeminine (4.01 times), transmasculine (2.91 times), and nonbinary (4.77 times)), as compared to those individuals questioning their gender. Black individuals (3.93 times) and Multiracial individuals (2.39 times) are more likely to experience dating violence than their White counterparts. Age was related to increased experience of forced sex, with individuals being 1.34 times more likely to have experienced this per year increase of age. These findings indicate the need for more trans-inclusive youth programing around sexual violence and dating violence, as well as taking a more intersectional and personalized approach to prevention work.

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Section: Discussionsupporting

confidence: 84%

Increased Prevalence, Predictors, and In-Group Differences of Forced Sex and Physical Dating Violence among Trans/Gender Diverse Youth

et al. 2021

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“…Our findings align with those from other research, namely that trans people commonly experience multilevel forms of stigma and discrimination when accessing health care of all kinds [9,[75][76][77] and, per the minority stress model, that these experiences can negatively impact health-seeking behaviours [43][44][45]. Among our sample, experiences of cisgenderism and transphobia were particularly prominent in 'general' health settings.…”

Section: Plos Onesupporting

confidence: 89%

“…Transgender and gender diverse people (henceforth 'trans') often encounter a range of barriers to health care, which can significantly undermine access to and quality of care [1][2][3][4][5][6][7]. Studies of trans experiences of health care indicate that clinical services and providers are often uninformed of the needs of, or are directly discriminatory towards, trans patients [8,9]. Despite clear and consistent evidence that trans people have unique and often unmet needs in the context of sexual health [10][11][12], little research has investigated barriers to this kind of care.…”

Section: Introductionmentioning

confidence: 99%

Cisgenderism and transphobia in sexual health care and associations with testing for HIV and other sexually transmitted infections: Findings from the Australian Trans & Gender Diverse Sexual Health Survey

et al. 2021

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Transgender and gender diverse people have unique risks and needs in the context of sexual health, but little is known about sexual health care for this population. In 2018, a national, online survey of sexual health and well-being was conducted with trans and gender diverse people in Australia (n = 1,613). Data from this survey were analysed to describe uptake of sexual health care and experiences of interpersonal and structural cisgenderism and transphobia. Experiences of cisgenderism and transphobia in sexual health care were assessed using a new, four-item scale of ‘gender insensitivity’, which produced scores ranging from 0 (highly gender sensitive) to 4 (highly gender insensitive). Logistic and linear regression analyses were conducted to determine if experiences of gender insensitivity in sexual health care were associated with uptake and frequency of HIV/STI testing in the 12 months prior to participation. Trans and gender diverse participants primarily accessed sexual health care from general practice clinics (86.8%), followed by publicly funded sexual health clinics (45.6%), community-based services (22.3%), and general hospitals (14.9%). Experiences of gender insensitivity were common overall (73.2% of participants reported ≥2 negative experiences) but most common in hospitals (M = 2.9, SD = 1.3) and least common in community-based services (M = 1.3, SD = 1.4; p<0.001). When controlling for sociodemographic factors, social networks, general access to health care, and sexual practices, higher levels of gender insensitivity in previous sexual health care encounters were associated with a lower likelihood of recent HIV/STI testing (adjusted prevalence ratio = 0.92, 95% confidence interval [CI]:091,0.96, p<0.001) and less-frequent HIV/STI testing (B = -0.07, 95%CI:-0.10,-0.03, p = 0.007). Given the high rates of HIV and other STIs among trans and gender diverse people in Australia and overseas, eliminating cisgenderism and transphobia in sexual health care may help improve access to diagnostic testing to reduce infection rates and support the overall sexual health and well-being of these populations.

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“…Regarding the control variables, nonbinary individuals (including both AMAB and AFAB) were significantly less likely to have had a provider who knew they were trans and treated them with respect than either trans men or trans women, which is interesting, given that a recent study found that nonbinary individuals were less likely to delay care due to fear of discrimination than their transfeminine counterparts (Kattari, Atteberry-Ash, Kinney, Walls, & Kattari, 2019). Nonbinary individuals were less likely to have had to educate providers; it is possible that they were also less likely to share (i.e., to be out about) their gender identity with their providers.…”

Section: Discussionmentioning

confidence: 98%

Correlations between healthcare provider interactions and mental health among transgender and nonbinary adults

Kattari

Bakko

Hecht

et al. 2020

SSM - Population Health

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Transgender and nonbinary patients have a wide array of experiences when attempting to access healthcare, including discrimination and having to educate providers about trans people. This study examines the mental health factors connected to transgender and nonbinary patients' experience with providers to determine the likelihood of transgender or nonbinary patients receiving respectful care after a provider knows about the patient's gender identity, and patients' experience of having to educate providers about trans people, controlling for sociodemographic factor. Using data from the 2015 United States Trans Survey (N = 27,715), chi-square tests of independence and multivariate logistic regressions were used to explore the odds of transgender or nonbinary individuals having a positive experience with a doctor or healthcare provider. Of the respondents, 24.31% experienced having to educate a provider about trans people when seeking care, and 62.90% experienced a provider knowing they were transgender or nonbinary and treating them with respect. Those experiencing depression and suicidal thoughts were significantly less likely to have had a provider treat them with respect, and significantly more likely to need to educate their providers. Gender, age, disability status, and educational level were significant across both variables; income was significant regarding having to educate a provider. Healthcare providers need ongoing training and education to improve their care of transgender and nonbinary patients, specifically around acknowledging the multiple backgrounds and experiences of such patients, including those related to mental health, gender, race, age, income, educational level, and disability.

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One size does not fit all: differential transgender health experiences

Cited by 53 publications

References 47 publications

Increased Prevalence, Predictors, and In-Group Differences of Forced Sex and Physical Dating Violence among Trans/Gender Diverse Youth

Increased Prevalence, Predictors, and In-Group Differences of Forced Sex and Physical Dating Violence among Trans/Gender Diverse Youth

Cisgenderism and transphobia in sexual health care and associations with testing for HIV and other sexually transmitted infections: Findings from the Australian Trans & Gender Diverse Sexual Health Survey

Correlations between healthcare provider interactions and mental health among transgender and nonbinary adults

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