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Transgender adults more likely to report diminished health

The transgender population is affected by diminished health-related quality of life more than cisgender individuals, according to a recent study published in JAMA Internal Medicine.

“These disparities require informed attention from clinicians and policy makers and further investigation by researchers,” Kellen E. Baker, MPH, MA, of the department of health policy and management at Johns Hopkins Bloomberg School of Public Health, wrote.

The CDC introduced an optional Sexual Orientation and Gender Identity module to the Behavioral Risk Factor Surveillance System (BRFSS) in 2014 to address the need for routine, standardized data collection to evaluate health in the transgender population. The module included the question “Do you consider yourself transgender,” and had primary answer options for respondents to identify as transgender male to female, transgender female to male, transgender and gender non-conforming, or not transgender. Researchers used responses to the question to identify transgender and cisgender adults and compared their responses to the BRFSS’s four-item set of Healthy Day questions, which measured health-related quality of life (HRQOL).

Between 2014 and 2017, the pooled data set classified 3,075 individuals, an estimated 0.55% (95% CI, 0.51-0.59) of the sample, as transgender, which would extrapolate to 1.27 million transgender people in the general population of the United States.

Compared to cisgender adults, those who identified as transgender were more likely to have experienced diminished HRQOL as higher odds of fair or poor health (adjusted OR = 1.3; 95% CI,1.03-1.62) or severe mental distress (aOR = 1.66; 95% CI, 1.36-2.01) in the last 30 days. Transgender adults also had more days of activity limitation (1.34 days; P < .001) and poor physical and mental health (1.2 days; P < .001). Transgender adults were less likely to have health insurance and reported more current cigarette use and physical inactivity than cisgender adults.

The results were limited and could not be generalized across the entire United States, as only 36 states and territories representing 75% of the population used the Sexual Orientation Gender Identity module at least once from 2014 to 2017.

“Given ongoing nationwide debates about public accommodations access, nondiscrimination protections, and other issues that influence transgender health, all states and territories should field the module to facilitate research that draws on fully representative samples of the US transgender population,” Baker wrote. – by Erin Michael

Disclosures: The authors report no relevant financial disclosures.