They “Don't Know How to Deal with People Like Me”: Assessing Health Care Experiences of Gender Minorities in Indiana

Newsom, Keeley D; Riddle, Michael J.; Carter, Gregory A.; Hille, Jessica J.

doi:10.1089/trgh.2021.0027

Cited by 5 publications

(3 citation statements)

References 27 publications

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“…Shorter travel time to one's PrEP provider was the third most important attribute among respondents regardless of PrEP status. Lack of geographically accessible medical services is an important barrier to attending medical visits, including visits for PrEP-related care, among people who reside in rural areas or impoverished neighbourhoods [22,103,[112][113][114]. Prior studies also found that even in large metropolitan areas, trans patients often reported that ride-share services were cost-prohibitive and travelling by public transportation was time-consuming or exposed them to discrimination or violence [27,115,116].…”

Section: Table 2 Results Of Choice-based Conjoint Analysis Experiment...mentioning

confidence: 99%

“…However, prior research with trans participants across other fields of research may inform this work. Recent quantitative studies have found that anti-trans stigma, the dearth of transinclusive sexual health programmes and medical mistreatment pose significant barriers to PrEP-related care [2,10,15,[20][21][22][23][24]. Qualitative studies have aligned with these findings and further described how structural factors such as anti-trans discrimination and disenfranchisement (e.g.…”

Section: Introductionmentioning

confidence: 97%

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HIV pre‐exposure prophylaxis programme preferences among sexually active HIV‐negative transgender and gender diverse adults in the United States: a conjoint analysis

Watson,

Listerud,

Drab

et al. 2024

J Int AIDS Soc.

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IntroductionCurrent implementation efforts have failed to achieve equitable HIV pre‐exposure prophylaxis (PrEP) provision for transgender and gender‐diverse (trans) populations. We conducted a choice‐based conjoint analysis to measure preferences for key attributes of hypothetical PrEP delivery programmes among a diverse online sample predominantly comprised of transmasculine and nonbinary individuals in the United States.MethodsBetween April 2022 and June 2022, a national online survey with an embedded conjoint analysis experiment was conducted among 304 trans individuals aged ≥18 years in the United States to assess five PrEP programme attributes: out‐of‐pocket cost; dispensing venue; frequency of visits for PrEP‐related care; travel time to PrEP provider; and ability to bundle PrEP‐related care with gender‐affirming hormone therapy services. Participants responded to five questions, each of which presented two PrEP programme scenarios and one opt‐out option per question and selected their preferred programme in each question. We used hierarchical Bayes estimation and multinomial logistic regression to measure part‐worth utility scores for the total sample and by respondents’ PrEP status.ResultsThe median age was 24 years (range 18–56); 75% were assigned female sex at birth; 54% identified as transmasculine; 32% as nonbinary; 14% as transfeminine. Out‐of‐pocket cost had the highest attribute importance score (44.3%), followed by the ability to bundle with gender‐affirming hormone therapy services (18.7%). Minimal cost‐sharing ($0 out‐of‐pocket cost) most positively influenced the attribute importance of cost (average conjoint part‐worth utility coefficient of 2.5 [95% CI 2.4−2.6]). PrEP‐experienced respondents preferred PrEP delivery in primary care settings (relative utility score 4.7); however, PrEP‐naïve respondents preferred pharmacies (relative utility score 5.1).ConclusionsParticipants preferred programmes that offered PrEP services without cost‐sharing and bundled with gender‐affirming hormone therapy services. Bolstering federal regulations to cover PrEP services and prioritizing programmes to expand low‐barrier PrEP provision are critical to achieving equitable PrEP provision. Community‐engaged implementation research conducted by and in close collaboration with trans community stakeholders and researchers are needed to streamline the design of patient‐centred PrEP programmes and develop implementation strategies that are salient to the diverse sexual health needs of trans patients.

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Section: Table 2 Results Of Choice-based Conjoint Analysis Experiment...mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 97%

HIV pre‐exposure prophylaxis programme preferences among sexually active HIV‐negative transgender and gender diverse adults in the United States: a conjoint analysis

Watson,

Listerud,

Drab

et al. 2024

J Int AIDS Soc.

View full text Add to dashboard Cite

show abstract

“…Transgender individuals are less likely to access healthcare than their cisgender counterparts, for reasons including discrimination and a lack of provider knowledge and comfort (National Academies of Sciences, Engineering, and Medicine, 2020; Newsom et al, 2022). As providers who are more comfortable and confident treating LGBTQIA+ patients leave states with legislation restricting GTP, health disparities faced by gender-diverse patients will likely be exacerbated.…”

Section: Discussionmentioning

confidence: 99%

Medical students' perspectives on transgender care legislation and its impact on medical residency applications

Kurman,

Ake,

Hille

2024

Sexuality Gender & Policy

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Many states have introduced bills restricting healthcare for transgender and gender‐diverse (TGD) individuals. This may prompt medical students to seek residency training in other states, exacerbating TGD healthcare disparities. We assessed medical students' perspectives on legislation prohibiting gender transition procedures (GTP) and how this affects residency applications. We analyzed responses from medical students at a Midwest institution, including demographics, knowledge of GTP legislation, impact on future training and practice, and agreement with proposed legislation. Respondents shared factors influencing their feelings about applying for residency in states that restrict GTP, as well as considerations informing their position about regulations. 36.8% consider GTP legislation important for residency applications. 60.5% think this will impact their future practice. 57.3% are against restricting GTP for minors, and 82.7% for adults. Factors influencing residency applications were LGBTQ+ safety (38.5%), government interference (33.3%), education/training (33.3%), neutral (20.5%), and against GTP (15.4%). Factors informing position on GTP were best practices (71.8%), consent (30.8%), government interference (30.8%), and need more data (7.7%). Most students surveyed were against the restriction of GTP, and legislation prohibiting GTP may drive physicians to other states. Responses also highlighted knowledge gaps about GTP, which may improve with additional training.

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“It’s just a general lack of awareness, that breeds a sense that there isn’t space to talk about our needs”: barriers and facilitators experienced by transgender people accessing healthcare in Aotearoa/New Zealand

González,

Veale

2024

International Journal of Transgender Health

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They “Don't Know How to Deal with People Like Me”: Assessing Health Care Experiences of Gender Minorities in Indiana

Cited by 5 publications

References 27 publications

HIV pre‐exposure prophylaxis programme preferences among sexually active HIV‐negative transgender and gender diverse adults in the United States: a conjoint analysis

HIV pre‐exposure prophylaxis programme preferences among sexually active HIV‐negative transgender and gender diverse adults in the United States: a conjoint analysis

Medical students' perspectives on transgender care legislation and its impact on medical residency applications

“It’s just a general lack of awareness, that breeds a sense that there isn’t space to talk about our needs”: barriers and facilitators experienced by transgender people accessing healthcare in Aotearoa/New Zealand

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