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Looking at Population Health Beyond “Male” and “Female”: Implications of Transgender Identity and Gender Nonconformity for Population Health

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  • Danya Lagos

    (University of Chicago)

Abstract

Looking beyond binary measurements of “male” or “female” can illuminate health inequality patterns that correspond to gender identity rather than biological sex. This study examines disparities in overall health among transgender men, transgender women, gender-nonconforming adults, and cisgender (nontransgender) men and women in the U.S. population. Behavioral Risk Factor Surveillance System (BRFSS) data from 32 U.S. states and territories between 2014 and 2016 yield an analytic sample that identifies 2,229 transgender and gender-nonconforming adults and 516,753 cisgender adults. Estimates from logistic regression models, using cisgender men as a reference group, show that gender-nonconforming respondents have significantly higher odds of reporting poor self-rated health than any other gender identity group. Transgender men also display higher odds of reporting poor health in some models, corresponding to their relative socioeconomic disadvantage. I find no apparent health disadvantage among transgender women and a persistent, if slight, disadvantage among cisgender women. Gender-nonconforming respondents’ predicted probabilities of reporting poor health remain nearly twice as high as those of cisgender men after adjustments for demographic, socioeconomic, and behavioral factors. Their persistent patterns of health-related disadvantage underscore the need for higher-quality data on gender-nonconforming respondents that account for sex assigned at birth.

Suggested Citation

  • Danya Lagos, 2018. "Looking at Population Health Beyond “Male” and “Female”: Implications of Transgender Identity and Gender Nonconformity for Population Health," Demography, Springer;Population Association of America (PAA), vol. 55(6), pages 2097-2117, December.
    • Handle: RePEc:spr:demogr:v:55:y:2018:i:6:d:10.1007_s13524-018-0714-3
    DOI: 10.1007/s13524-018-0714-3
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    2. Christopher S. Carpenter & Gilbert Gonzales Jr. & Tara McKay & Dario Sansone, 2020. "Effects of the Affordable Care Act Dependent Coverage Mandate on Health Insurance Coverage for Individuals in Same-Sex Couples," NBER Working Papers 26978, National Bureau of Economic Research, Inc.
    3. Ethan C Cicero & Sari L Reisner & Elizabeth I Merwin & Janice C Humphreys & Susan G Silva, 2020. "The health status of transgender and gender nonbinary adults in the United States," PLOS ONE, Public Library of Science, vol. 15(2), pages 1-20, February.
    4. Everhart, Avery R. & Ferguson, Laura & Wilson, John P., 2022. "Construction and validation of a spatial database of providers of transgender hormone therapy in the US," Social Science & Medicine, Elsevier, vol. 303(C).
    5. Campbell, Travis & Rodgers, Yana van der Meulen, 2023. "Conversion therapy, suicidality, and running away: An analysis of transgender youth in the U.S," Journal of Health Economics, Elsevier, vol. 89(C).

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