Transgender Women Face High Rates of Employment Discrimination and Health Care Access Barriers

Atlanta, Georgia – A recent survey revealed that a significant number of transgender women in the United States have experienced various forms of discrimination, particularly in the workplace. The study, conducted by the Atlanta Department of Public Health, found that seven in 10 transgender women reported acts of transphobic discrimination, with one in three stating that they faced discrimination in employment.

The prevalence of discrimination among transgender women in the survey, known as NHBS-Trans, showed both similarities and differences compared to previous studies. Notably, the survey participants in NHBS-Trans, who were predominantly Black or Hispanic with lower socioeconomic status, reported higher instances of discrimination in various areas, including bathroom discrimination, treatment in businesses, verbal and physical abuse, but lower prevalence of housing and health care discrimination when compared to the 2015 U.S. Transgender Survey, which had predominantly White participants with higher socioeconomic status.

Furthermore, the study highlighted the overlapping nexus of poverty, homelessness, incarceration, health insurance, disability, food insecurity, and survival sex work, all of which are interconnected with employment discrimination. The refusal to hire economically marginalized transgender women can contribute to further economic hardships, potentially leading to engagement in survival sex work and even incarceration. The study also found that a third of transgender women with a disability reported trouble finding employment, indicating high rates of employment discrimination among this demographic.

Employment discrimination was also found to be associated with poorer health care access, including being uninsured, having unmet medical needs due to cost, and never having transgender-specific health care. This lack of access can be particularly detrimental for transgender women, as it affects their ability to choose gender-affirming providers, engage in care, and access necessary health care services.

The study also revealed that Medicaid was the most common source of insurance coverage for transgender women, many of whom have an HIV-positive diagnosis and/or a disability. However, the availability and coverage of gender-affirming care through Medicaid varies by state, posing a barrier to necessary health care for transgender individuals with low income.

Additionally, the survey found that most transgender women visited a health care provider or currently use hormones, indicating a strong motivation to seek health care and pursue hormone therapy to achieve their transition goals. However, the relation of unmet need for gender-affirming procedures with employment discrimination highlights the structural barriers to health care access faced by transgender women.

Overall, the study sheds light on the widespread discrimination faced by transgender women in the United States, particularly in the realms of employment and health care, emphasizing the need for systemic changes and interventions to address these disparities.