Comparing the Health of Transgender Women, Transgender Men, and Gender Non-Conforming Individuals Using Population-Level Data

Abstract

Converging evidence indicates transgender and gender non-conforming (TGNC) individuals generally experience poorer health than their cisgender counterparts. Less is known about TGNC health across gender identity subgroups. Extant work has yielded mixed findings, precluding conclusions regarding the comparative health of transgender women, transgender men, and gender non-conforming individuals. Additionally, this work is limited methodologically, e.g., utilizing convenience samples and operationalizing “transgender” differently across studies. This study aims to improve upon these limitations, and more broadly add to the literature on within-group health differences among TGNC individuals. We used 2016 U.S. population-level data (N = 1,117), conducting MANCOVA (multivariate analysis of covariance) and logistic regression to compare the health of transgender women, transgender men, and GNC individuals. Health outcomes of mental and physical health, substance use, and healthcare access/utilization were selected based on empirical and theoretical support for their relevance to TGNC health. We also completed interaction analyses to test the intersectional effects on health of gender identity and emergent sociodemographic variables, e.g. race/ethnicity. Across TGNC subgroups, individuals reported similar alcohol use, mental health, and healthcare access/utilization. Transgender men reported worse physical health than their counterparts, and GNC individuals reported lower smoking prevalence than their counterparts. Interaction analyses by race/ethnicity indicated Hispanic transgender women reported worse physical health than other Hispanic TGNC individuals, while Black transgender men, Multiracial GNC individuals, and Hispanic transgender women reported worse mental health than some of their intra-racial/ethnic TGNC counterparts. Findings add to the growing literature on TGNC health and highlight TGNC subgroups that may be vulnerable regarding mental and physical health.