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Health and Health Care Access in the U.S. Transgender Population Health (TransPop) Survey


Feldman, Jamie L.; Luhur, Winston E.; Herman, Jody L.; Poteat, Tonia; & Meyer, Ilan H. (Online ahead of print). Health and Health Care Access in the U.S. Transgender Population Health (TransPop) Survey. Andrology.


BACKGROUND: Probability and nonprobability-based studies of U.S. transgender persons identify different disparities in health and health care access.
OBJECTIVES: We used TransPop, the first U.S. national probability survey of transgender persons, to describe and compare measures of health and health access among transgender, nonbinary and cisgender participants. We directly compared results with 2015 U.S. Transgender Survey (USTS) data and with previously published analyses from the Behavioral Risk Factor Surveillance System (BRFSS).
METHODS: All participants were screened by Gallup, Inc., which recruited a probability sample of U.S. adults. Transgender people were identified using a two-step screening process. Eligible participants completed self-administered questionnaires (transgender n = 274, cisgender n = 1,162). We obtained weighted proportions/means, then tested for differences between gender groups. Logistic regression was performed to evaluate associations. Bivariate analyses were conducted using the weighted USTS data set for shared variables in USTS and TransPop.
RESULTS: Transgender, compared to cisgender, participants were younger and more racially diverse. Despite equally high insurance coverage, transgender people more often avoided care due to cost. Nonbinary persons were less likely to access transgender related health care providers/clinics than transgender men and women. Transgender, compared to cisgender, respondents more often rated health as fair/poor, with more poor physical and mental health days. Health conditions including HIV, emphysema, and ulcer, were higher among transgender people. TransPop and USTS, unlike BRFSS-based analyses, showed no differences in health or health access.
DISCUSSION: Transgender persons experience health access disparities centered on avoidance of care due to cost beyond insured status. Health disparities correspond with models of minority stress, with nonbinary persons having distinct health/health access patterns. Despite different sampling methods, USTS and TransPop appear more similar than BRFSS studies regarding health/health access.
CONCLUSION: Future research should elucidate health care costs for transgender and nonbinary people, while addressing methodology in national studies of transgender health. This article is protected by copyright. All rights reserved.


Reference Type

Journal Article

Article Type


Year Published

Online ahead of print

Journal Title



Feldman, Jamie L.
Luhur, Winston E.
Herman, Jody L.
Poteat, Tonia
Meyer, Ilan H.


United States of America