Identifying the Transgender Population in the Medicare Program.

Area of Science:

• Health Services Research
• Demographics
• Public Health

Background:

• Understanding the demographics of transgender individuals within large healthcare systems is crucial for equitable care.
• Administrative data, such as Medicare claims, offer a potential resource for identifying and characterizing underserved populations.

Purpose of the Study:

• To identify and describe the transgender population enrolled in the Medicare program.
• To assess the feasibility of using administrative claims data for transgender population research.

Main Methods:

• Utilized International Classification of Diseases, ninth edition (ICD-9) codes for transsexualism and gender identity disorder.
• Analyzed over 1 billion Medicare Fee-For-Service claims from 2013.
• Applied a multistage validation process including diagnoses, billing codes, and hormone prescriptions.

Main Results:

• Identified 4,098 transgender beneficiaries in Medicare.
• Approximately 90% of identified individuals had confirmatory diagnoses, billing codes, or hormone prescription evidence.
• The transgender Medicare population's age, entitlement status, and disease burden differ from the general Medicare population, though racial, ethnic, and geographic distributions are similar.

Conclusions:

• Administrative data are a valuable resource for estimating the size of the transgender Medicare population.
• This study provides a baseline description of the transgender Medicare population's characteristics and health status.
• The findings establish a framework for future research on transgender healthcare access and needs within Medicare.