School of Social Work, University of Washington, 4101 15th Avenue NE, Seattle, WA, 98105, USA.
School of Social Work, New York University, New York, NY, USA.
Arch Sex Behav. 2022 May;51(4):1913-1925. doi: 10.1007/s10508-022-02302-x. Epub 2022 May 20.
Trans people tend to utilize health care at rates lower than cisgender people, which commonly results in short-term and long-term unfavorable health outcomes. Theoretically informed by Andersen's behavioral model of health services use and Lerner and Robles' adapted behavioral model of health services use for transgender people, the current study examined how individual characteristics of trans people along with the external environment and health care service environment they must navigate impact their health care utilization. Binary logistic regression was used to analyze data from the 2015 United States Trans Survey (N = 27,715), the largest trans sample to date. Perception of health care provider (HCP) knowledge, health insurance status, and health care costs each produced the strongest effect on visiting a doctor or HCP in the past year. The results showed that having a provider that had some level of knowledge about trans people was potentially most critical to increase utilization. Discussion points include increasing trans-focused curriculum in health professional schools, utilizing trans standardized patients in health professional schools, and holding insurance companies accountable to provide trans affirming care.
跨性别者的医疗保健利用率往往低于顺性别者，这通常会导致短期和长期的不良健康后果。本研究以安德森健康服务使用行为模型和勒纳和罗夫莱斯为理论基础，为跨性别者改编的健康服务使用行为模型，探讨了跨性别者的个体特征以及他们必须应对的外部环境和医疗保健服务环境如何影响他们的医疗保健利用。本研究使用二元逻辑回归分析了 2015 年美国跨性别调查（N=27715）的数据，这是迄今为止最大的跨性别者样本。对医疗保健提供者（HCP）知识、保险状况和医疗保健费用的感知对过去一年中看医生或 HCP 的影响最大。结果表明，拥有对跨性别者有一定了解的提供者可能是增加利用率的关键。讨论要点包括增加健康专业学校的跨性别焦点课程，在健康专业学校使用跨性别标准化患者，以及要求保险公司承担提供跨性别认同护理的责任。
