Abstract
Purpose: Transgender, including gender diverse and nonbinary (trans), people experience significant health disparities. We aimed to better understand the health status and needs of Australian trans people to guide resources and health and well-being programs.Methods: This anonymous, cross-sectional online survey utilized nonprobability snowball sampling of Australian adults (18 years and over) who self-identified as trans between September 2017 and January 2018. This descriptive study assessed demographic data, community views on access to health care, health burden, access to health resources, and priorities for government funding in transgender health.Results: Of 928 participants, 37% reported female, 36% reported male, and 27% reported nonbinary gender identities. Despite 47% having tertiary qualifications, the unemployment rate was 19%, with 33% reporting discrimination in employment due to being trans. Discrimination in accessing health care was reported by 26% and verbal abuse and physical assault were reported by 63% and 22%, respectively. Lifetime diagnosis of depression was reported by 73% and anxiety by 67%. Sixty-three percent reported previous self-harm and 43% had attempted suicide. Autism spectrum disorder and attention-deficit/hyperactivity disorder were reported by 15% and 11%, respectively. The most preferred method of receiving health information was through online resources, with the most popular source being Reddit, an online peer discussion board. Better training for doctors in trans health issues was the top priority for government funding.Conclusions: Barriers, including widespread discrimination and unemployment, contribute to health inequity and prevalent mental health conditions. Better training for health professionals in the provision of safe, gender-affirming and general health care for trans people is urgently required.
Highlights
Discrimination in accessing health care was reported by 26% and verbal abuse and physical assault were reported by 63% and 22%, respectively
The number of transgender, including gender diverse and nonbinary, individuals seeking genderaffirming health care worldwide is rising,[1] yet global studies have demonstrated that trans people face many barriers to accessing health care, including discrimination[2] and the inability to find doctors willing to provide care,[3] as well as high rates of depression and attempted suicide.[1,4]
The survey social media post was shared by 275 individuals and transgender support groups on the social media site Facebook
Summary
The number of transgender, including gender diverse and nonbinary (trans), individuals seeking genderaffirming health care worldwide is rising,[1] yet global studies have demonstrated that trans people face many barriers to accessing health care, including discrimination[2] and the inability to find doctors willing to provide care,[3] as well as high rates of depression and attempted suicide.[1,4] Mental health distress is driven, in part, by barriers to accessing health care as well as by discrimination.[1,5–8] In addition, cooccurring autism spectrum disorders (ASD) and attentiondeficit/hyperactivity disorder (ADHD) may be more prevalent among trans individuals for unclear reasons, with difficulties with attention or social interaction potentially posing greater barriers by affecting the ability to understand health information or engage in clinical care.[1,9]There are little data describing the health of the Australian adult trans population. The number of transgender, including gender diverse and nonbinary (trans), individuals seeking genderaffirming health care worldwide is rising,[1] yet global studies have demonstrated that trans people face many barriers to accessing health care, including discrimination[2] and the inability to find doctors willing to provide care,[3] as well as high rates of depression and attempted suicide.[1,4]. Mental health distress is driven, in part, by barriers to accessing health care as well as by discrimination.[1,5–8]. There are little data describing the health of the Australian adult trans population. Due to a lack of population data, it is unknown how many Australians identify as trans. A nonpeer-reviewed publication described very high levels of mental health conditions, depression and anxiety syndromes, poor quality of life, and high rates of discrimination among Australian trans adults in 2013 (Ref.[10]).
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