National Healthcare Disparities Report - LDI Health Economist

Priority Populations
criminal justice, and identity documents. The health findings are presented here. More extensive
demographic and methodological information can be accessed in the original report, Injustice at Every Turn:
A Report of the National Transgender Discrimination Survey.
Access to Health Care
A majority of study participants sought care through a doctor’s office (60%); however, a significant minority
used health centers and clinics (28%).
Chapter 10
Figure 10.1. Primary source of medical care, LGBT population, 2008
100
Primary Source of Medical Care for Respondents
90
80
70
60
60%
50
40
30
20
17%
10
0
4%
ER
Doctor’s
office
Health
center
7%
Free
clinic
4%
VA
2%
Alternative
provider
Source: Reprinted from the National Transgender Discrimination
Survey Report on Health and Health Care, 2011.
Four percent of respondents primarily used emergency rooms (ERs) for care. Several studies have shown that
individuals who use ERs for primary care experience more adverse health outcomes than those who regularly
see a primary physician. x Factors that correlated with increased use of ERs were:
n Race—17% of African Americans used ERs as did 8% of Latino/a respondents.
n Income—8% of respondents earning under $10,000 per year used ERs.
n Employment status—10% of unemployed respondents and 7% of those who had lost their jobs due
to bias used ERs.
n Education—13% of those with less than a high school diploma used ERs.
Visual conformers xi and those who had identity documents that matched their presentation had the highest
rates of using doctor’s offices for their care.
x
For example, Foraselli P, DeAngelis C, Kaszuba A. Compliance with followup appointments generated in a pediatric emergency
room. Am J Prev Med 1985;1(3); Chande VT, Krug SE, Warm EF. Pediatric emergency department utilization habits: a consumer
survey. Pediatr Emerg Care 1996;12(1).
xi Visual conformers are defined as respondents who believed their presentation matched their gender identity. This study notes the
significance of visual nonconformity as a risk factor in eliciting antitransgender bias and its attendant social and economic burdens.
242 National Healthcare Disparities Report, 2011