University of Colorado School of Medicine, Aurora, USA.
Department of Obstetrics, Gynecology, and Women's Health Rutgers , New Jersey Medical School, Newark, NJ, USA.
J Gen Intern Med. 2018 Oct;33(10):1654-1660. doi: 10.1007/s11606-018-4450-6. Epub 2018 May 15.
Transgender people, those whose gender identity does not match their sex assigned at birth, face barriers to receiving health care. These include discrimination, prohibitive cost, and difficulty finding transgender-inclusive providers. As transgender identities are not typically recognized in public health research, the ability to compare the health of the transgender population to the overall population is limited.
The Colorado Transgender Health Survey sought to explore current disparities and their effects on the health of transgender people in Colorado.
The Colorado Transgender Health Survey, based on the Behavioral Risk Factor Surveillance System (BRFSS), was developed by the Colorado Department of Public Health and Environment, transgender advocates, and transgender community members. Outreach was targeted to transgender-inclusive events and organizations.
Responses to the 2014 Colorado Transgender Health Survey were compared side by side to Colorado 2014 BRFSS data.
Results from 406 transgender or gender-nonconforming adults who live in Colorado were included in the analysis. Forty percent of respondents report delaying medical care due to cost, inadequate insurance, and/or fear of discrimination. Respondents report significant mental health concerns, with 43% reporting depression, 36% reporting suicidal thoughts, and 10% attempting suicide in the past year. Respondents with a transgender-inclusive provider were more likely to receive wellness exams (76 versus 48%), less likely to delay care due to discrimination (24 versus 42%), less depressed (38 versus 54%), and less likely to attempt suicide (7 versus 15%) than those without.
The transgender community in Colorado faces significant disparities, especially around mental health. However, a transgender-inclusive provider is associated with improved mental and physical health and health behaviors. Further population-level research and provider education on transgender health should to be incorporated into national efforts to eliminate health disparities.
跨性别者，即其性别认同与其出生时被分配的性别不符的人，在获得医疗保健方面面临障碍。这些障碍包括歧视、过高的费用以及难以找到跨性别包容的提供者。由于跨性别者的身份在公共卫生研究中通常不被认可，因此将跨性别者群体的健康状况与总体人口进行比较的能力受到限制。
科罗拉多跨性别者健康调查旨在探索科罗拉多州跨性别者目前面临的差异及其对他们健康的影响。
科罗拉多跨性别者健康调查基于行为风险因素监测系统（BRFSS），由科罗拉多州公共卫生与环境部、跨性别倡导者和跨性别社区成员共同开发。外展工作针对跨性别包容的活动和组织进行。
将 2014 年科罗拉多跨性别者健康调查的回复与 2014 年科罗拉多 BRFSS 数据进行并排比较。
在分析中纳入了 406 名居住在科罗拉多州的跨性别或性别不符合常规的成年人的回复。40%的受访者因费用、保险不足和/或担心歧视而延迟医疗护理。受访者报告存在严重的心理健康问题，其中 43%报告抑郁，36%报告有自杀念头，10%在过去一年中试图自杀。有跨性别包容提供者的受访者更有可能接受健康检查（76%对 48%），因歧视而延迟护理的可能性较小（24%对 42%），抑郁程度较低（38%对 54%），试图自杀的可能性较小（7%对 15%）。
科罗拉多州的跨性别者群体面临着严重的差异，尤其是在心理健康方面。然而，跨性别包容的提供者与改善的心理健康和身体健康以及健康行为相关。应将针对跨性别健康的进一步人群研究和提供者教育纳入消除健康差异的国家努力中。
