Summary
Summary: Policy protections for transgender adults in the United States are consistently associated with positive health outcomes. However, studies over-represent non-Latinx, white transgender people and obscure variation in policies’ intended goals. This study examined racial differences in the relationship between transgender-related policies and transgender women’s self-rated health.
Researchers hypothesized that policies conferring access to resources (e.g., health care) would be associated with better self-rated health among all participants while policies signifying equality (e.g., nondiscrimination laws) would be associated with better self-rated health only for white participants.
Using cross-sectional data collected between March 2018–December 2020 from 1,566 transgender women, authors analyzed 7 state-level ‘access policies,’ 5 ‘equality policies,’ and sum indices of each. Participants represented 29 states, and 54.7% were categorized as people of color.
Findings: In bivariate models, 4 access policies, 2 equality policies, and both indices were associated with better self-rated health, but associations did not persist in adjusted models. Results indicated that policies concerning private insurance coverage of gender-affirming care, private insurance nondiscrimination, credit nondiscrimination, and both indices were statistically significantly associated with better self-rated health for white participants and worse self-rated health for participants of color.
The policies included in this analysis do not mitigate racism’s effects on access to resources, indicating they may be less impactful for transgender women of color than white transgender women. Future research and policy advocacy efforts promoting transgender women’s health must center racial equity as well as transgender people of color’s priorities.
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