Health of Transgender Adults in the U.S., 2014–2016

Introduction: Transgender people experience significant interpersonal and structural discrimination and stigma. However, little is known about the health of transgender people, and even less about the health of specific groups—including male-to-female, female-to-male, and gender-nonconforming transgender populations—despite the variation in social and biological characteristics across groups. Methods: Data are from the 2014–2016 Behavioral Risk Factor Surveillance System, analyzed in 2017. The study population included 2,221 transgender and 523,080 cisgender respondents from 31 states and one territory. The authors estimated the prevalence and adjusted odds of chronic health conditions, health-related quality of life, disabilities, health behaviors, and health utilization among three transgender groups, when compared separately with cisgender males and cisgender females. Results: An estimated 0.24% (95% CI=0.21, 0.27) identified as male-to-female; 0.14% (95% CI=0.12, 0.17) identified as female-to-male; and 0.10% (95% CI=0.08, 0.12) identified as gender-nonconforming. All transgender groups experience worse mental health and disabilities; few differences in healthcare access and utilization were observed. Gender-nonconforming people had higher odds of multiple chronic conditions, poor quality of life, and disabilities than both cisgender males and females. Female-to-male people had a higher odds of no exercise and cardiovascular disease compared with cisgender females. Conclusions: Given the high burden of disabilities; poor mental health; and multiple chronic conditions among transgender (particularly gender-nonconforming) populations, supportive services and care coordination may be consequential levers for improving transgender health.