Addressing Needs of Transgender Patients: The Role of Family Physicians

Asa E. Radix, MD, PhD, MPH


J Am Board Fam Med. 2020;33(2):314-321. 

In This Article

Health Disparities for Transgender People

Transgender people face significant health disparities, mainly related to stigma and discrimination, as well as unique barriers to health care.[8,12] A large US-based survey revealed that about 1 in 3 transgender people had a negative health care experience in the past year related to their gender identity and approximately 1 in 4 avoided care due to concerns about mistreatment in health settings.[7] Transgender people frequently encounter medical professionals who lack expertise in gender-affirming care. Even when they find health care providers who are able to provide quality care, they may face additional barriers, such as health insurance plans that exclude gender-affirming medical care or surgeries.[7] Several studies indicate that transgender people may be less likely to use preventive care services, such as cervical and colon cancer screening.[32,33] In some cases transgender people face may face denial of coverage for preventive care services when a gender mismatch is perceived (e.g., cervical cytology for a transgender man).

Compared with the general population, transgender people, especially transgender women of color, face significant psychosocial disparities, including higher rates of homelessness, unemployment, and poverty.[7,34] Many have experienced physical violence as well as school and workplace harassment.[7] It is no surprise that transgender individuals have higher rates of mental health issues (anxiety and depression), substance use disorders, and violence as a consequence of these factors.[7,35]