Why talk about TGNBI health?
We discuss Transgender, Non-Binary, and Intersex (TGNBI) health, because we know that health outcomes for TGNBI people are poorer, that the health equity are not the same across the TGNBI community, and that knowledgeable, inclusive, and affirming healthcare and public health providers are often identified as one of the biggest barriers to accessing care and services.
Health outcomes for TGNBI people are poorer
Transgender and Non-Binary (TGNB) people report poorer health outcomes compared to cisgender people. Over a third (34%) of TGNB people report their health as fair or poor, compared to 13.6% of the general U.S. population. With almost half (44%) experiencing serious psychological distress in the last 30 days. (US Trans Survey 2022)
The few studies that have focused on the health and well-being of Intersex people, have found that almost half (43%) report their health as fair or poor, with a greater likelihood of experiencing chronic illness, disability, depression, and anxiety compared to the general U.S. population. (Rosenwohl-Mack, et al. 2020)
Uniquely, we see that young gender-expansive people experience high prevalence of serious psychological distress (including anxiety and depression) compared to cisgender LGB people as is reflected in this illustration from the Trevor Project. (Trevor Project, 2023)
BlPOC TGNBI people are disproportionally impacted
Across research studies, TGNBI people who hold multiple socially marginalized identities disproportionately experience poorer health outcomes.
Black, Indigenous, Latine and other TGNB people of color are more likely to be living with a chronic illness, HIV, or experiencing serious psychological distress compared to white TGNBI people. (US Trans Survey, 2015)
When we look at intersections of age and ability, we also find that TGNB younger people are more likely to experience negative health outcomes and that TGNB people are more likely to have a disability and experience negative health outcomes because of how TGNB people and disabled people are treated in health systems. (Price-Feeney, et al., 2020; Mulcahy, et al., 2022)
Intersex people have a unique experience, with some intersex people identifying as cisgender and some as TGNB. However the health experiences of Intersex people are often similar to experiences of TGNB people regardless of gender identity, with an emphasis on "fixing" intersex people instead of meeting their health needs. (InterACT, n.d.)
Lack of affirming and knowledgeable health services are a significant barrier to care
TGNBI people consistently report experiences of discrimination, stigma, and a lack of knowledgeable health service providers as a barrier to getting health needs met.
One-quarter (24%) of TGNB people did not see a doctor in the past year due to fear of mistreatment, and almost half (48%) of those who did see a doctor in the past year reported at least one negative experience because they were TGNB. (US Trans Survey, 2022).
For Intersex people, especially LGBTQ+ identified Intersex people, avoidance of health services are even higher. Almost two-thirds (61%) of LGBTQ+ Intersex people avoided doctor's offices for fear of discrimination, and 88% experienced some form of discrimination when accessing health care. (Center for American Progress, 2021)
Experiences of and fear of discrimination and mistreatment leads to delay of accessing medical care, ultimately reducing access to preventive care, treatment, and health screening. This results in poorer health outcomes including increased experiences of preventable health conditions and need for emergency treatment.
By educating and increasing provider capacity to serve TGNBI people and communities, we will reduce health disparities and improve health outcomes.
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