A comparison of health disparities among transgender adults in Colorado (USA) by race and income

ABSTRACT

Transgender individuals face heightened risks for discrimination, harassment, and violence that impact their psychosocial well-being and physical health. However, few studies have thoroughly examined the general physical and mental health of transgender adults or within-group health differences by race/ethnicity and income. To that end, after controlling for health insurance status, age, and engagement in exercise, this study asks: (a) Are transgender people of color more likely than White transgender individuals to experience poor health outcomes? and (b) Is lower annual household income among transgender adults associated with poorer health outcomes? The study analyzes secondary data from a survey of transgender adults (N = 417) in one state in the western United States using multiple linear regression and logistic regression models. Results showed that transgender people of color had significantly greater odds than their White counterparts of having arthritis/rheumatoid arthritis/gout/lupus/fibromyalgia, or asthma but lower odds of being told by a provider that they had depression. Having a lower income was significantly associated with worse general health as well as multiple indicators of poor physical and mental health, including depression, anxiety, and suicidal ideation. We discuss implications for health care delivery for transgender people and for future research.

KEYWORDS:

• Transgender
• health
• mental health
• race
• income

Acknowledgments

We would like to thank Dr. Lionel Scott and Dr. Brent Teasdale for their constructive feedback about our statistical analyses.

Funding

Dr. Seelman's time on this project was supported by the National Institutes of Health Loan Repayment Program for Health Disparities Research through the National Institute on Minority Health and Health Disparities.

Notes

1. Each person who participated in the survey had to identify as transgender or gender nonconforming. However, some individuals within the transgender community identify their primary identity as either man or woman following a transition; these subgroups are captured here.

2. This was calculated using the inverse odds ratio: .