Oral Healthcare-Seeking Behavior among Transgenders in Kerala: A Cross-Sectional Study

Transgender individuals face significant health disparities, including limited access to appropriate healthcare services. This study aimed to assess the oral healthcare-seeking behavior (HSB) of transgender people in Kerala. A cross-sectional study was conducted between July 2022 and September 2023 among 120 transgender individuals by using snowball sampling. Participants completed a self-administered questionnaire assessing their oral HSB. The Chi-square test was used to analyze the association of sociodemographic variables with oral health knowledge, attitude, and dental service utilization. Statistical significance was set at P < 0.05. The mean age of the participants was 29.12 ± 8.19 (95% Cl = 27.6-30.6) years. Transwomen comprised 70.8% (95% Cl = 61-78) of the participants, compared to 29.2% (95% Cl = 21-38) of transmen. Participants with good oral health knowledge comprised 60.8% (95% Cl = 51-69), and 57.5% (95% Cl = 48-66) had a positive attitude. The majority (82.5%) (95% Cl = 74-88) utilized dental services for toothaches and restorations. Bivariate analysis revealed higher dental service utilization among participants with higher education (P = 0.03), and a significant difference between transmen and transwomen was seen (P = 0.04, OR = 2.69, 95% Cl = 1.0-7.0). The main barriers were treatment costs (P = 0.001 OR = 5.3, 95% Cl = 1.94-14.4) and discrimination. Financial constraints and gender discrimination hinder transgender individuals' access to oral healthcare. Sensitizing oral healthcare providers and implementing targeted policies can reduce disparities and promote health equity.