Stigma’s impact--hiding your transgender identity from your doctor

In a recent article in the Journal of Gay & Lesbian Social Services, author D. Kyle Sutherland analyzed data from the Virginia Transgender Health Initiative Study (THIS), 2005-2006 (ICPSR 31721), retrieved from the Resource Center for Minority Data. A multi-phase, multi-year project to improve the health of transgender Virginians, THIS data can be used by researchers to better understand the causes of trans health disparities due to social stigma. THIS includes a one-time quantitative survey, conducted with adults who had attended school in Virginia and who self-identified as transgender. The survey measured demographics, access to regular medical services, access to transgender care services, employment discrimination, housing discrimination, sexual and physical violence, social support and self-esteem, suicidal ideation and attempts, substance abuse and tobacco use, HIV knowledge and perception of risk, HIV risk behaviors, HIV testing and status, and access to HIV/AIDS prevention and treatment services.

Sutherland cited previous research indicating trans people have more difficulty than CIS gender people in securing a primary care physician, therefore may more often need to seek health care from unfamiliar health care providers. Sutherland wanted to understand the factors contributing to any reluctance that trans patients may have in disclosing their status to these providers, and so used THIS data “to examine the relationship between demographic characteristics, experiences with discrimination, interpersonal supports, and levels of discomfort discussing a trans-identity and health needs with an unknown physician.” Among Sutherland’s findings: roughly a quarter of the study participants reported experiencing harassment and discrimination by a doctor in a health care setting, and those individuals were “at greater odds of feeling discomfort communicating with an unfamiliar physician.” The data also reveal a link between school-related trans discrimination and negative health outcomes like poor mental health and unhealthy coping mechanisms. And Sutherland found that “victims of school harassment from students, teachers, and administrators were more likely to express feelings of discomfort disclosing and discussing their trans identity and health needs to unfamiliar providers.” More publications using THIS data can be found on the study’s home page.