Gender Nonconforming, Transgender, and Transsexual Patient Navigation of the American Health Care System: Locating a Primary Care Provider

Abstract

GENDER NONCONFORMING, TRANSGENDER, AND TRANSSEXUAL PATIENT NAVIGATION OF THE AMERICAN HEALTH CARE SYSTEM: LOCATING A PRIMARY CARE PROVIDER By Justin Michael Vinneau, M.S. A thesis submitted in partial fulfillment of the requirements for the degree of Master of Science at Virginia Commonwealth University Virginia Commonwealth University Major Director: Dr. Susan Bodnar-Deren, Assistant Professor, Sociology This study explores the experiences of gender nonconforming (GNC), transgender, and transsexual (trans) people in the search for a primary care provider in the United States. The current body of literature on transgender health often discusses HIV rates, substance use, mental health/suicide, and few studies have studies primary care seeking behaviors; this study seeks to provide new insight into the primary care (pcp) seeking behaviors of GNC and trans people. The primary theoretical perspectives utilized in this study were West and Zimmerman’s (1987) “Doing Gender” and the Health Beliefs Mode (Ayers et al., 2007; Connor and Norman, 2005; Green and Murphy, 2014). In order to explore the pcp seeking behaviors among GNC and trans individuals, I designed a 45 item survey. The survey was posted on-line on three separate “sub-reddits” between March and April of 2016 and was open to all individuals who selfidentified as gender nonconforming, transgender, and/or transsexual. Of 96 responses, 68 were included. Although the sample is small, the results showed that structural barriers were significantly associated with having a PCP. Those with health insurance (p=.031) and those with at least one chronic illness (p=.037) were more likely to have a regular primary care provider. Descriptive findings support the role of socioGender Nonconforming, Transgender, and Transsexual Patient Navigation v economic factors, geographic location, and past experiences of discrimination as predictors of primary care status.