TDNet Discover

Background: The number of people deciding to transition has steadily increased over the past decade. However, many transgender individuals come across obstacles that increase the amount of time it takes for them to begin the process. The correlation between time to transition and demographics has been studied, but the correlation between time to transition and health literacy has not. Purpose: The purpose of this study was to determine if a correlation between time to gender affirming hormone therapy (GAHT) and transgender health literacy exists. Secondary outcomes of the number of providers and number of visits were also investigated for possible correlations with health literacy. The study aimed to obtain quantitative and qualitative data to provide robust insight into the experiences of the participants. Methods: PubMed was utilized prior to the design of the study to investigate the research question and determine the breadth of the current literature. Nine peer-reviewed articles and three reputable sources were ultimately analyzed. These sources informed the study design process. A survey was then designed and developed on the platform Qualtrics. The questions address demographics, patient health literacy, provider health literacy, time to GAHT, and the provider’s perceived knowledge about treating transgender patients. The survey was distributed to consenting transgender participants ≥ 18 years old via nationwide social media and the data was analyzed for statistically significant correlations. Results: A total of 107 participants met the inclusion criteria of residing in the U.S., being at least 18 years old, identifying as transgender, and having received gender-affirming hormone treatment or hormone replacement therapy. Statistically significant correlations were found between time to GAHT/HRT and both perceived provider understanding of transgender healthcare (p = 0.0007) and perceived self-impact (p = 2.34e-7). No statistically significant (p < 0.05) correlation was found for access to general/transgender specific healthcare information or general/transgender specific healthcare literacy and primary or secondary outcome groups. Additionally, no statistically significant correlations were found between demographic data and the primary outcome groups. Conclusion: The data gathered from this study indicates that many transgender individuals felt that provider education on transgender healthcare and their own understanding of GAHT impacted how quickly they could begin GAHT. Although this study was small and recall bias may be at play, it is clear when taking the results of other studies into account that provider education on transgender healthcare needs to improve to ensure that transgender individuals can begin GAHT more quickly. Further studies that focus on prospective cohorts and incorporate provider responses as well as clinic data would be helpful to control for biases in order to increase the validity of results.