Exposure to Childhood Healthcare Discrimination and Healthcare Avoidance among Transgender and Gender Independent Adults during a Global Pandemic

Kyle Liam Mason; Shelby A Smout; Catherine S J Wall; B Ethan Coston; Paul B Perrin; Eric G Benotsch

doi:10.3390/ijerph19127440

Exposure to Childhood Healthcare Discrimination and Healthcare Avoidance among Transgender and Gender Independent Adults during a Global Pandemic

Int J Environ Res Public Health. 2022 Jun 17;19(12):7440. doi: 10.3390/ijerph19127440.

Authors

Kyle Liam Mason¹, Shelby A Smout¹, Catherine S J Wall¹, B Ethan Coston², Paul B Perrin¹, Eric G Benotsch¹

Affiliations

¹ Health Psychology, Department of Psychology, Virginia Commonwealth University, Richmond, VA 23284, USA.
² Department of Gender, Sexuality, & Women's Studies, Virginia Commonwealth University, Richmond, VA 23284, USA.

Abstract

Transgender and gender-independent individuals (TGI) encounter myriad barriers to accessing affirming healthcare. Healthcare discrimination and erasure exposure among TGI individuals is vital to understanding healthcare accessibility, utilization behaviors, and health disparities in this population. Exposure to gender identity-related healthcare discrimination and erasure in childhood may contribute to TGI adults' healthcare utilization behaviors. The commonality of childhood exposure to gender identity-related healthcare discrimination and its relationship to healthcare avoidance during the early months of the COVID-19 pandemic among TGI adults were explored. TGI adults aged 18 to 59 (N = 342) in the United States were recruited online during the summer of 2020. Among individuals who reported childhood exposure to gender identity-related healthcare discrimination, 51% reported experiencing two or more distinct forms of discrimination. Hierarchical logistic regression indicated that exposure to healthcare discrimination in childhood significantly increased the odds of healthcare avoidance during the early months of the COVID-19 pandemic, after accounting for demographic factors and self-reported COVID-19 symptoms (odds ratio = 1.30, 95% confidence interval = 1.10, 1.54). These findings suggest that childhood exposure to gender identity-related healthcare discrimination is a prominent barrier to the utilization of healthcare for TGI adults, even during a global pandemic.

Keywords: COVID-19 pandemic; United States; gender identity; health; healthcare; healthcare access; healthcare discrimination; healthcare utilization; transgender; vulnerable populations.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
COVID-19* / epidemiology
Female
Gender Identity
Health Services Accessibility
Humans
Male
Pandemics
Transgender Persons*
United States / epidemiology

Grants and funding

This research received no external funding. Developmental support for this research was provided by the final author of this manuscript, E.G.B. and C.S.J.W., solely and was supported by the National Science Foundation through the Graduate Research Fellowship under grant NO. 202030782.