Abstract
OBJECTIVESTransgender people may encounter barriers to transition-related healthcare services. This study aimed to investigate the experiences of transition-related healthcare and barriers to those procedures among transgender adults in Korea.METHODSIn 2017, we conducted a nationwide cross-sectional survey of 278 transgender adults, which named Rainbow Connection Project II, in Korea. We assessed the prevalence of transition-related healthcare, including gender identity disorder (GID) diagnosis, hormone therapy, and sex reassignment surgery. To understand the barriers to those procedures, we also asked participants for their reasons for not receiving each procedure. Further, this study examined their experiences of and the reasons for using non-prescribed hormone medications.RESULTSOf transgender people participated in the survey, 91.0% (n=253/278) were diagnosed with GID, 88.0% (n=243/276) received hormone therapy, and 42.4% (n=115/271) have had any kind of sex reassignment surgery. Cost was the most common barrier to transition-related healthcare among Korean transgender adults. Other common barriers were identified as follows: negative experiences in healthcare settings, lack of specialized healthcare professionals and facilities, and social stigma against transgender people. Among those who had taken hormone medications, 25.1% (n=61/243) reported that they had ever purchased them without a prescription.CONCLUSIONSOur findings suggest that barriers to transition-related healthcare exist in Korea and constrain transgender individuals’ safe access to the needed healthcare. Institutional interventions are strongly recommended to improve access to transition-related healthcare. These interventions include provision of programs to train Korean healthcare professionals and expansion of national health insurance to include these procedures.
Highlights
Transgender people have a gender identity or expression that is inconsistent with their legal sex at birth [1,2]
This study aimed to investigate the experiences of and barriers to transition-related healthcare, including gender identity disorder (GID) diagnosis, hormone therapy, and sex reassignment surgery, for transgender adults in Korea
The results suggest that 91.0% of surveyed transgender adults were diagnosed with GID, 88.0% had received hormone therapy, and 42.4% had undergone at least one kind of transition-related surgery
Summary
Transgender people have a gender identity or expression that is inconsistent with their legal sex at birth [1,2]. Transgender individuals can be classified as transwoman, transman, non-binary trans gender person, etc. Cisgender people have a gender identity or expression that matches their legal sex at birth [4]. In the US, prevalence of the transgender population was estimated to be 390 per 100,000 individuals [5]. By extrapolating the estimated frequency of transgender individuals from the metaanalysis study to the total Korean population, which is 51,635,256 as of February 2018 [6], there are an estimated 201,377 transgender individuals in Korea
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