Assessing the Influence of Stigma and Discrimination on Barriers to Health Care Access in Transgender Populations

Authors

  • Seema Mehta McMaster University

Abstract

Introduction/Background: The current pace of change in the recognition, awareness, and understanding of transgender issues have encouraged more individuals to acknowledge and accept their gender identities today than in any previous generation (1). Despite recent progress in the rights of sexual and gender minorities, health care systems and providers around the world are struggling to respond to this unprecedented rise in patients presenting with gender dysphoria. As a result, there has been an overall failure in adequately caring for transgender individuals, leading them to face significant barriers and challenges in their access to health care.

Findings: Considerable evidence has shown that transgender patients perceive substantial discrimination in health care settings (2). Most health care providers have minimal experience interacting with a diverse patient population and are largely unaware of sexual minority health issues and terminology. Recent studies have demonstrated that providers generally feel unprepared to offer quality care to transgender patients, illustrating a significant gap in the medical curriculum and training of these professionals (2). Beyond this lack of clinical competence, transgender individuals are often severely mistreated by medical providers (3). In a recent study of discrimination and health care experiences of LGBT patients in the United States, 20.9% of transgender patients reported being subjected to harsh language by a health care provider and 15% stated that their provider refused to touch them. 20.3% also reported being blamed for their own health problems and more than 25% stated that they were blatantly denied care due to their identity (4). Even when they are offered care, gender dysphoria is often treated as a psychiatric illness, rather than a matter of diversity. Constituting a form of unjust discrimination and a violation of self-determination, transgender patients are compelled to undergo mental assessments before pursuing gender affirmation surgeries (5).

Conclusions: Given this discrimination, transgender populations are less likely than the general population to seek primary care and attention for life-threatening issues, causing them to suffer poorer health outcomes. As a group that is also unequally affected by significant psychological distress, debilitating depression, substance abuse, sexually transmitted infections and high suicide rates, it is imperative that these health care disparities be addressed (2).

Author Biography

Seema Mehta, McMaster University

Department of Global Health, Faculty of Health Sciences

MSc Student

References

1. Jones RP, Cox D, Navarro-Rivera J. A shifting landscape: A decade of change in American attitudes and same-sex marriage and LGBT issues. Washington, DC: Public Religion Research Institute. 2014. Available from: http://publicreligion.org/site/wp-content/uploads/2014/02/2014.LGBT_REPORT.pdf.

2. Fallin-Bennett K. Implicit bias against sexual minorities in medicine. Acad Med. 2015; 90(5). Available from: http://doi.org/10.1097/ACM.0000000000000662

3. Poteat T, German D, Kerrigan D. Managing uncertainty: A grounded theory of stigma in transgender health care encounters. Soc Sci Med. 2013; 84: 22–29. Available from: http://doi.org/10.1016/j.socscimed.2013.02.019

4. Lambda L. When health care isn’t caring: Lambda Legal’s survey of discrimination against LGBT people and people with HIV. New York: Lambda Legal; 2010.

5. Selvaggi G, Giordano S. The role of mental health professionals in gender reassignment surgeries: unjust discrimination or responsible care? US Aesthet Plast Surg. 2014. Available from: http://doi.org/10.1007/s00266-014-0409-0

Downloads

Published

2015-12-30

How to Cite

Mehta, S. (2015). Assessing the Influence of Stigma and Discrimination on Barriers to Health Care Access in Transgender Populations. Global Health: Annual Review, 1(1). Retrieved from https://journals.mcmaster.ca/ghar/article/view/1062