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Health Insurance Prevalence Among Gender Minority People: A Systematic Review and Meta-Analysis
Kristen D Clark1, Athena D F Sherman2, Annesa Flentje1,3
1Department of Community Health Systems, School of Nursing, University of California San Francisco, San Francisco, California, USA.
Health insurance coverage for gender minority (GM) adults in the U.S. is 75%, significantly lower than the general population. This highlights disparities in access to care for transgender individuals.
Area of Science:
- Health Services Research
- Sociology of Health
- Public Health Policy
Background:
- Historically, gender minority (GM) individuals face lower health insurance rates.
- Disparities in insurance access can create barriers to essential healthcare services.
Purpose of the Study:
- To assess health insurance prevalence among U.S. gender minority adults.
- To examine insurance prevalence stratified by gender identity.
- To analyze trends in insurance coverage pre- and post-Affordable Care Act.
Main Methods:
- Systematic review of PubMed, EMBASE, and Web of Science databases.
- Meta-analysis using a random-effects model for pooled prevalence estimation.
- Heterogeneity assessed using Q-test and I² measure.
Main Results:
- Pooled health insurance prevalence for GM adults is 75% (CI: 0.71-0.79).
- Prevalence was 70% for transgender women and 80% for transgender men.
- Insufficient data for gender-expansive individuals precluded analysis.
Conclusions:
- Health insurance prevalence among GM adults remains substantially lower than the general population.
- Standardized gender data collection is crucial for identifying and addressing healthcare access barriers.
- Improved data collection can facilitate access to preventative and acute care for vulnerable GM populations.
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