Healthcare, risk assessment, diagnosis and treatment rarely conform to fit a “one size fits all” model. Although the concept of personalized medicine predates the major scientific and technological advancements that have shaped modern medicine, the growth of the pharmaceutical industry, and scientific advancements have facilitated the current practice of personalized medicine: “health care that is informed by each person’s unique clinical, genetic, and environmental information”.
In order to better understand the wide breadth of patients that seek medical care in North America, public health scientists and medical professionals have directed a specialized research focus to identify the unique health needs of gender minorities, such as transgender and gender-nonconforming individuals. In 2013, the Centers for Disease Control (CDC) created a gender identity question module as part of the Behavioral Risk Factors Surveillance System, the United States’ leading system of health-related telephone surveys. This system, which collects and tracks state data related to the health-related risk behaviours, use of preventative services, and chronic health conditions, was implemented in 2014 and employed over the next two years to examine the health status of gender minorities in the United States compared with their cisgender (a person whose sense of personal identity and gender corresponds with their birth sex) peers.
From the 2014 and 2015 survey, over 315,000 individuals were questioned, including 1,443 people who identified as a gender minority. The survey participants were evaluated on self-reported “outcomes”, such as overall health status; limitations in any activities due to physical, mental, or emotional problems; and serious difficulty concentrating, remembering, or making decisions because of a physical, mental, or emotional condition. Based on prior literature, the study considered other potentially confounding factors, such as sociodemographic characteristics, proxies for health care access, health conditions, and health behaviours (such as alcohol and cigarette consumption). Once the data was collected and analyzed, the following results were revealed:
Compared to cisgender adults, gender minority adults were:
- Less likely to be non-Hispanic white
- Less likely to be married or living with a partner
- Less likely to have a minor child in the household
- Less likely to be English speaking
- More likely to have a lower income
- More likely to be unemployed
- More likely to be uninsured
- More likely to have unmet medical care due to cost
- More likely to be overweight
- More likely to report depression
- More likely to report poor or fair health
- More likely to have difficulty concentrating, remembering, or making decisions
- More likely to be limited in any way
While the generalizability of these findings is limited because not all regions of the United States participated in the study, the results suggest that disparities in the health of American gender minority adults and their cisgender peers do indeed exist. Further research is needed more precisely define these disparities. Investigators speculate that the discrimination experienced by gender minorities tends to exacerbate worsening health outcomes in these populations. The study suggests reducing health disparities by utilizing the standardized questions of the CDC-approved module to collect widespread gender identity data, and urging public health professionals to pay close attention to the health and wellbeing of vulnerable populations.
Written By: Jordyn Posluns, B.Sc. (Hons.)