Factors Affecting Public Opinion on the Denial of Healthcare to Transgender Persons

Abstract

Between one-fifth and a third of people who are transgender have been refused treatment by a medical provider due to their gender identity. Yet, we know little about the factors that shape public opinion on this issue. We present results from a nationally representative survey experiment ( N = 4,876) that examines how common justifications issued by providers for the denial of healthcare, and the race and gender identity of the person being denied care, intersect to shape public opinion concerning the acceptability of treatment refusal. We find that religious objections are viewed as less acceptable compared to a medical justification, in this case, inadequate training. However, the difference between religious objections and inadequate training is larger when the person being denied healthcare is White or Asian than when the person is Black or Latinx. Analysis of open-ended responses indicates the modest effect of doctor’s rationale on attitudes toward treatment refusal with respect to Black and Latinx patients is partially attributable to a racialized, free-market logic. Respondents were more likely to advocate for a doctor’s fundamental right to refuse service when evaluating Black and Latinx patients compared to White patients. We discuss the implications of these findings for intersectional approaches to trans studies and future public opinion research.