Table 3.

Association Between Insurance Claim Denial and Gender-Affirming Hormone Use Among Insured Respondents to the 2015 US Transgender Survey

Characteristic	Use of Nonprescription Hormones, Among Those Using Hormones^a (n = 10,841)		Use of Hormones, Among Those Interested (n = 18,516)
Characteristic	aOR (95% CI)	P Value	aOR (95% CI)	P Value
Claim for hormones denied by insurance	2.53 (1.61-3.97)	<.001	0.89 (0.57-1.39)	.60
Age (for each additional year)	0.98 (0.96-0.99)	<.001	0.97 (0.95-0.99)	.02
Gender identity (compared with trans man)
Trans woman	5.42 (3.56-8.25)	<.001	0.54 (0.34-0.86)	.009
Assigned female at birth, genderqueer/nonbinary	1.54 (0.83-2.86)	.17	0.13 (0.07-0.23)	<.001
Assigned male at birth, genderqueer/nonbinary	8.90 (3.22-24.62)	<.001	0.80 (0.25-2.30)	.70
Race (compared with White)
Alaska Native/American Indian	0.55 (0.19-1.55)	.26	0.53 (0.15-1.80)	.30
Asian/Native Hawaiian/Pacific Islander	4.04 (0.95-17.29)	.06	1.05 (0.44-2.46)	.92
Biracial/multiracial/not listed	3.22 (1.76-5.90)	<.001	0.84 (0.42-1.69)	.62
Black/African American	1.33 (0.70-2.54)	.39	1.17 (0.60-2.27)	.65
Latinx/Hispanic	1.31 (0.63-2.73)	.47	1.05 (0.46-2.41)	.90
Middle Eastern/North African	6.49 (1.07-39.28)	.04
Education (compared with less than high school)
High school	1.24 (0.37-4.11)	.72	0.34 (0.11-1.11)	.07
Some college	1.09 (0.35-3.37)	.87	0.56 (0.19-1.63)	.29
Bachelor’s degree or higher	0.94 (0.28-3.20)	.92	0.40 (0.13-1.19)	.10
At or near poverty	0.72 (0.30-1.21)	.22	0.79 (0.50-1.25)	.32

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.