A first-of-its-kind statewide survey of transgender, nonbinary and gender expansive/nonconforming (TNG) youth shows a lack of access to TNG-centered health care and insurance in Wisconsin.
“The clear majority of youth surveyed say they can’t find medical or mental health providers who understand their needs,” said Dr. Britt Allen, assistant professor of pediatrics. Based on previous population-level data, the report estimates that there may be as many as 9,800 to 12,400 TNG youth between the ages of 12 and 22 in Wisconsin.
Allen teamed up with co-investigator Dr. Jennifer Rehm, assistant professor of pediatrics, lead author Jay Botsford of the Transgender Youth Resource Network (TYRN), and the Wisconsin Transgender Health Coalition, for the study.
In addition to the survey, the study included five focus groups from around the state. Surveys were completed in 2017 by 311 TNG youth. Among the findings:
- Eighty percent of TNG youth do not have a medical provider who is aware of the health needs of TNG youth.
- Fifty-five percent had to provide basic information about TNG health to medical providers and 65 percent to mental-health providers.
- Twenty-eight percent avoided or were unable to access necessary health care within the last year.
- Eighty-one percent have insurance, yet only 38 percent of respondents have coverage for some TNG-specific or transition-related health care. Less than 3 percent cover all care.
- Seventy percent and 64 percent respectively had negative experiences with their medical or mental-health-care providers through language, refusal of care, denial of identity or lack of provider knowledge.
“TNG young people deserve access to high-quality and affirming services, resources and care throughout their lives so that they can successfully grow into affirmed, safe and thriving adults,” said Rehm.
The report makes the following recommendations:
- Provide thorough education and training to healthcare and mental health providers about TNG youth communities, identities, needs and health.
- Identify and eliminate systemic, policy, procedural and practice barriers to care for TNG youth within all healthcare systems.
- Ensure both public and private health insurance cover TNG-specific and transition-related health care of all kinds.
- Replace gatekeeping models to provide TNG-specific and transition-related health care with patient-centered models of care.
- Establish policies, systems and/or services to address and minimize parental/guardian rejection or lack of support as a barrier to health care for TNG youth.
- Develop services to help TNG youth navigate health-care systems, advocate for their needs, and access affirming resources.
Partners in the survey include the Department of Pediatrics, the Transgender Youth Resource Network, and the Wisconsin Transgender Health Coalition. Administrative support was provided by the Child Health Advocacy department of UW Health’s American Family Children’s Hospital.
UW Health offers a Pediatric and Adolescent Transgender Health Clinic (PATH) which provides care for TNG children and young adults. The Gender Services program offers gender-affirming care for adults.
Funding for the study was provided by Baldwin Wisconsin Idea Foundation, the UW BIRCWH program and the UW Institute for Clinical and Translational Research.
See the full report here.