Factors Associated With Health Care Utilization Among Transgender Adults in Brazil

This study investigated the utilization of medical and dental services by transgender Brazilians and their associated factors.

A national cross-sectional survey was conducted in 2021 with 549 self-identified transgender adults (231 male, 183 female, and 135 other gender) aged 18-61 years. Participants were recruited through social media using snowball sampling and answered an electronic structured questionnaire. Outcomes were the frequency of medical and dental appointments. Associated factors included sociodemographic characteristics, use of social name, partnership, children, religion, health information sources, perceived health needs, experience of gender-based violence, and type of health services used. Odds ratios (OR) with 95% confidence intervals (CIS) were estimated using backward stepwise logistic regression models.

Respondents who attended public schools (OR 1.73; 95% CI 1.01-2.88), had no income (OR 1.96; 95% CI 1.01-3.85), and relied solely on the public health system (OR 2.48; 95% CI 1.36-4.50) were more likely to have semiannual medical consultations. Conversely, those who attended public schools (OR 1.89; 95% CI 1.09-3.31), had ≤ 9 years of schooling (OR 1.74; 95% CI 1.13-2.68), were unemployed (OR 1.88; 95% CI 1.04-3.42), or had experienced gender-based violence (OR 1.57; 95% CI 1.02-2.41) were more likely to rarely or never attend dental consultations.

Transgender Brazilians predominantly used the public health system, attending medical consultations semiannually but rarely dental appointments. Lower education, unemployment, lack of income, and exposure to gender-based violence shaped healthcare utilization, highlighting persistent barriers to equitable and comprehensive health access.