Improving access to transgender-friendly health care can help reduce the burden on ERs


Transgender people who come to the emergency room for care are more likely to be hospitalized than cisgender people if they visit the ER, according to research being presented Saturday at ENDO 2023. Endocrine Society Annual Meeting, Chicago, IL

“Our findings can help reduce discrimination against transgender people in society and health care and improve the outpatient care they can receive in the community, helping them stay healthy and avoid ER visits,” said lead researcher Daphne Stromsa, MD, MPH, University of Michigan in Ann Arbor, Mich. “Improving transgender-friendly health care will help improve the health of this population and reduce the burden on emergency rooms and hospitals.”

More than 1.6 million people over the age of 13 in the United States are transgender and gender nonconforming. Because of social discrimination, they face many problems getting the health care they need, Stromsa said. Fearing discrimination from some medical providers — a common experience among transgender people — they often avoid seeking care until they are very ill. Transgender people may need to use emergency room services for basic services, or for untreated chronic conditions. The study examined ER visits unrelated to gender-affirming medical care.

In the new study, the researchers analyzed data from a group of databases known as the National Emergency Department Sample. Between 2006 and 2018, a total of 66,382 visits were made by people who identified as transgender.

The researchers found a rapid increase in the rate of visits by people who identified as transgender, from 0.001% of visits in 2006 to 0.016% in 2018. There were significant demographic differences between transgender and cisgender patients. Transgender and gender-diverse people are more likely to receive it, adjusting for pay, age group, region, income and mental health status (52.4% and 17.3% overall, respectively). A higher proportion of ED visits in transgender and gender-diverse individuals were associated with a chronic condition (58.2% vs. 19.2%) and/or a mental health diagnosis (28.7% vs. 3.9% for others). Among transgender and gender-diverse people, hospitalization was more likely to be associated with a chronic illness (67.3% vs. 41.3%) or a mental health condition (37.2% vs. 5.3%).

“Higher admission rates, and higher rates of transgender and gender diverse people with chronic illnesses or mental health problems may represent poor overall health due to a lack of primary care, or delays in seeking emergency care across gender and gender. Diverse People , “Stroumsa said. “Discrimination and transphobia have direct consequences, undermine the health of transgender people, and lead to poor use of health care resources. There is a need to increase access to affirmative primary and mental health care among transgender and gender-diverse people.”


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