Transgender Health Disparities: Comparing Full Cohort and Nested Matched-Pair Study Designs in a Community Health Center

Sari L. Reisner · Jaclyn M. W. Hughto · Judith Bradford · Matthew J. Mimiaga

205 citations0/0 files storedLGBT Health

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LGBTQ Health, Identity, and Policy HIV/AIDS Research and Interventions Health disparities and outcomes

Abstract

Purpose: U.S. health surveillance systems infrequently include measures to identify transgender respondents or monitor the health of this underserved and marginalized population. Methods: From 2001 to 2002, transgender and nontransgender adults were sampled at a Massachusetts clinic. Health differences were formatively examined by transgender identity using a cross-sectional, clinic-based sample (n=2,653) and a nested matched-pair subsample (n=155). Results: Both designs produced virtually identical findings: (1) the prevalence of HIV, substance abuse, and smoking did not differ significantly for transgender and nontransgender patients; (2) transgender patients were more likely to endorse a lifetime suicide attempt and ideation compared with nontransgender patients (p<0.05); (3) transgender patients disproportionately reported social stressors (violence, discrimination, childhood abuse) relative to nontransgender patients (p<0.05). Conclusion: Findings suggest that a nested design may provide an effective methodology for using clinical data to study transgender health and underscore the need for routine collection of gender identity in clinical settings.

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2012The Health of lesbian, gay, bisexual, and transgender people: building a foundation for better understanding 2005HEALTH DISPARITIES AND HEALTH EQUITY: Concepts and Measurement 1992Assessing for Abuse During Pregnancy 2006Attempted Suicide Among Transgender Persons 2012Experiences of Transgender-Related Discrimination and Implications for Health: Results From the Virginia Transgender Health Initiative Study 2002Gender Violence 2008Sexual and Gender Minority Health: What We Know and What Needs to Be Done 2001HIV prevalence, risk behaviors, health care use, and mental health status of transgender persons: implications for public health intervention

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