跨性别和性别多样性医疗保险受益人的性别确认手术
Em Balkan1,2, Gray Babbs1,2, David J Meyers1,2
1Department of Health Services, Policy & Practice, Brown University School of Public Health, Providence, Rhode Island.
JAMA network open
|May 1, 2025
概括
在医疗保险受益者中,性别确认手术是罕见的,在老年人和居住在南方的人群中观察到的比例较低. 对于跨性别人士来说,获得这些程序的机会因地区而异.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 跨性别者健康 跨性别者健康
- 医学社会学 医学社会学
背景情况:
- 医疗保险对性别确认外科手术的覆盖范围是根据具体情况决定的.
- 在医疗保险受益者中,这些程序的使用率在很大程度上是未知的,这凸显了对理解访问和趋势的差距.
研究的目的:
- 调查医疗保险受益人中性别确认外科手术的频率和时间趋势.
- 分析与在医疗保险人口中接受性别确认手术相关的人口和临床特征.
主要方法:
- 一项利用2016年1月1日至2020年2月29日的国家医疗保险数据进行的横截面研究.
- 通过基于索赔的算法识别跨性别和性别多样化的受益者,使用倾向分数匹配选择非跨性别个人.
- 用描述性分析和概括估计方程来评估程序率和相关的受益人特征.
主要成果:
- 在医疗保险受益者中,确立性别的外科手术是罕见的,其利用率从2016-2017年的2.1%-2.2%下降到2018-2019年的1.4%.
- 接受手术的跨性别受益者比没有接受手术的受益者更有可能年轻,双重注册医疗保险和医疗补助,患有多种慢性疾病,居住在西海岸州.
- 在跨性别受益者中观察到程序收件的区域差异很大,南方的比例低于东北部,而非跨性别受益者没有发现此类区域差异.
结论:
- 医疗保险受益者很少使用性别确认手术程序,基于年龄,社会经济地位和地理位置存在显著差异.
- 对于跨性别的医疗保险受益者来说,在获得性别确认手术方面存在实质性的区域差异,这强调了进一步调查进入障碍的必要性.
- 为了了解和解决障碍,防止跨性别和性别多样化的受益者获得必要的性别确认手术护理,需要进行额外的研究.
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