Barriers to primary care seen by transgender patients

Lack of physicians, long distances and excessive wait times are three barriers that transgender and gender-diverse adult patients face in seeking healthcare, according to a new study.

Transgender individuals have more chronic conditions but are less likely to have had a primary care visit in the last year than cisgender individuals, said the study announced by the Regenstrief Institute, in conjunction with Indiana University (IU) School of Medicine and Eskenazi Health of Indianapolis.

Transgender individuals are those who maintain a gender identity that is different from the gender they were assigned at birth. A cisgender person is someone whose sense of personal identity and gender corresponds with their sex assigned at birth.

Researchers interviewed 21 patients in the Gender Health Program at Eskenazi Health in Indianapolis, a comprehensive healthcare clinic for transgender and gender-diverse adults, said a news release from Regenstreif Institute.

They found transgender patients in Indiana face barriers related to:

• A lack of willing or knowledgeable providers
• Geography
• Long wait times for appointments

The study cited comments from transgender patients about their experiences with healthcare providers.

“When we spoke to these patients, many described difficulties in being able to find a provider that could or would treat them. Some traveled for hours just so they could be seen in an affirming setting with providers knowledgeable about transgender health,” said first author Joy L. Lee, PhD, M.S., research scientist at Regenstrief Institute and assistant professor of medicine at IU School of Medicine. “These interviews speak to the need for more primary care providers who can treat transgender patients and highlight the need to create healthcare spaces that feel safe for transgender individuals.”

The study was noteworthy for highlighting experiences of rural transgender patients in the Midwest, said Janine M. Fogel, M.D., co-author, medical director of the Gender Health Program at Eskenazi Health and assistant professor of clinical family medicine and clinical medicine at IU School of Medicine.

“A supportive care environment, whether it is a specialty clinic or a primary care office, is so crucial for these individuals who have many unique needs,” Fogel said. The study, “’I Don’t Want to Spend the Rest of My Life Only Going to a Gender Wellness Clinic’: Healthcare Experiences of Patients of a Comprehensive Transgender Clinic,” was published online ahead of print in the Journal of General Internal Medicine.

This article was originally published by sister publication Medical Economics.