Association Between Insurance Status and Gender-Affirming Hormone Use Among Respondents to the 2015 US Transgender Survey
| Characteristic | Use of Nonprescription Hormones, Among Those Using Hormonesa (n = 12,037) | Use of Hormones, Among Those Interested (n = 21,237) | ||
|---|---|---|---|---|
| aOR (95% CI) | P Value | aOR (95% CI) | P Value | |
| Uninsured (compared with insured) | 2.64 (1.88-3.71) | <.001 | 0.37 (0.24-0.56) | <.001 |
| Age (for each additional year) | 0.986 (0.975-0.996) | .008 | 0.969 (0.96-0.98) | <.001 |
| Gender identity (compared with trans man) | ||||
| Trans woman | 3.71 (2.30-5.00) | <.001 | 0.56 (0.40-0.77) | <.001 |
| Assigned female at birth, genderqueer/nonbinary | 2.41 (1.25-4.65) | .009 | 0.16 (0.10-0.23) | <.001 |
| Assigned male at birth, genderqueer/nonbinary | 6.02 (2.82-12.82) | <.001 | 0.19 (0.10-0.39) | <.001 |
| Race (compared with White) | ||||
| Alaska Native/American Indian | 0.49 (0.22-1.09) | .08 | 0.93 (0.35-2.44) | .88 |
| Asian/Native Hawaiian/Pacific Islander | 2.72 (0.94-7.89) | .06 | 1.30 (0.65-2.62) | .45 |
| Biracial/multiracial/not listed | 3.28 (1.92-5.61) | <.001 | 1.23 (0.76-1.98) | .39 |
| Black/African American | 0.92 (0.55-1.56) | .77 | 0.75 (0.40-1.38) | .35 |
| Latinx/Hispanic | 1.07 (0.60-1.89) | .82 | 1.01 (0.51-1.97) | .98 |
| Middle Eastern/North African | 3.68 (0.66-20.45) | .14 | 2.06 (0.50-8.39) | .31 |
| Education (compared with less than high school) | ||||
| High school | 1.38 (0.62-3.08) | .43 | 0.47 (0.19-1.17) | .10 |
| Some college | 1.32 (0.63-2.78) | .46 | 0.56 (0.24-1.27) | .16 |
| Bachelor’s degree or higher | 1.13 (0.51-2.50) | .76 | 0.50 (0.22-1.15) | .10 |
| At or near poverty level | 0.80 (0.57-1.13) | .20 | 0.76 (0.51-1.14) | .19 |
aOR = adjusted odds ratio.
Note: Data analyzed using weighted multivariable logistic regression. For all analyses, crossdressers were excluded from the overall sample because of their unique characteristics.
↵a Analysis excluded respondents currently in active military service, given their unique pathways to accessing gender-affirming hormones.