Health risks for trans­gen­der peo­ple

Re­search shows an in­creased like­li­hood of be­ing over­weight, unin­sured, de­pressed.

Los Angeles Times - - CALIFORNIA - KAREN KA­PLAN karen.ka­plan@la­times.com

Be­ing trans­gen­der in Amer­ica may be haz­ardous to your health.

A new re­port in JAMA In­ter­nal Medicine char­ac­ter­izes a va­ri­ety of health dis­par­i­ties be­tween peo­ple who are trans­gen­der (that is, their gen­der iden­tity is not the same as their sex at birth) and peo­ple who are cis­gen­der (their gen­der iden­tity matches their sex at birth).

Spoiler alert: There are many.

The data come from the Be­hav­ioral Risk Fac­tor Sur­veil­lance Sys­tem, a health sur­vey spon­sored by the Cen­ters for Dis­ease Con­trol and Preven­tion. In 2014, 20 states added ques­tions about gen­der iden­tity; five more joined them the fol­low­ing year.

Re­searchers from Brigham & Women’s Hos­pi­tal and Beth Is­rael Dea­coness Med­i­cal Cen­ter, both af­fil­i­ated with Har­vard Med­i­cal School in Bos­ton, ex­am­ined re­sponses from 314,450 cis­gen­der and 1,443 trans­gen­der in­ter­vie­wees. Peo­ple who de­scribed them­selves as trans­gen­der ac­counted for less than half of 1% of the en­tire sam­ple.

Over­all, the trans­gen­der peo­ple were younger, poorer, less white and more likely to be un­em­ployed than their cis­gen­der coun­ter­parts.

The re­searchers also found sig­nif­i­cant health dif­fer­ences be­tween the two groups. Among them:

Trans­gen­der adults were less likely to de­scribe them­selves as healthy.

The CDC asks Amer­i­cans to de­scribe their over­all health as ex­cel­lent, very good, good, fair or poor. The re­searchers re­ported that 29% of trans­gen­der adults rated their health as fair or poor, com­pared with 17% of cis­gen­der adults.

Trans­gen­der adults were more likely to be over­weight.

Just un­der 66% of cis­gen­der adults had a body mass in­dex of at least 25, qual­i­fy­ing them as over­weight. That may sound high, but it was sig­nif­i­cantly lower than the 72% share for the trans­gen­der adults.

Trans­gen­der adults were more likely to be unin­sured.

Nearly 21% of trans­gen­der adults lacked health in­sur­ance when they were sur­veyed. By com­par­i­son, only about 11% of cis­gen­der adults did not have health in­sur­ance.

Trans­gen­der adults were more likely to let a health prob­lem go un­treated.

More than 1 in 5 trans­gen­der adults said they had let a health prob­lem fester be­cause they couldn’t af­ford to get the nec­es­sary treat­ment. In con­trast, 1 in 8 cis­gen­der adults were in the same predica­ment.

Trans­gen­der adults were more likely to be de­pressed

Among the trans­gen­der adults who took the sur­vey, 22.3% had been di­ag­nosed with de­pres­sion. That was sig­nif­i­cantly higher than the 18.4% of cis­gen­der adults who got that di­ag­no­sis.

Trans­gen­der adults had more cog­ni­tive prob­lems.

When asked whether they had any prob­lems with “con­cen­trat­ing, remembering or mak­ing de­ci­sions,” 10% cis­gen­der and 18% of trans­gen­der adults an­swered yes.

The study doesn’t make the claim that be­ing trans­gen­der is the rea­son for the health dis­par­i­ties. But the dif­fer­ences were too big to be due to chance.

The study au­thors noted that since th­ese re­sults were based on sur­vey re­sponses from only some of the states, they might not re­flect the health sta­tus of trans­gen­der peo­ple across the coun­try.

How­ever, they were strong enough to make one thing clear, they wrote: “This study con­firms that gen­der mi­nor­ity adults in the United States ex­pe­ri­ence health dis­par­i­ties com­pared with their cis­gen­der peers.”

Ir­fan Khan Los An­ge­les Times

TRANS­GEN­DER peo­ple are younger, poorer, less white and more likely to be un­em­ployed than peo­ple whose gen­der iden­tity matches their sex at birth, data show. Above, a poster at a clinic in South L.A. in 2015.

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