NASTAD’s Transgender Health Issue Brief: Ensuring Equitable Access to Gender-Affirming Care and Treatment

By Joe Caldwell August 3, 2016

Nearly fifty years ago, in 1966, transgender and LGB activists in the Tenderloin district of San Francisco took a stand to protest police brutality in what was later known as the Compton’s Cafeteria Riot. While this served as a stepping stone for other major movements for LGBT individuals, most notably the Stonewall riots in 1969, transgender and gender-nonconforming people have continued to face undeniable socioeconomic barriers. In the world of HIV, numerous studies have estimated disease prevalence among transgender women to be around 28% with an especially disparate impact on black trans women of color.

In order to address the continued challenges and barriers to care of many transgender and gender nonconforming individuals, NASTAD released Crossroads: ADAP Considerations for Transgender Health. The issue brief is designed to advance providers’ and ADAPs’ awareness of transgender health issues, highlight public and private insurance considerations, and ultimately improve clinical outcomes. This brief focuses on three areas for ADAP staff and providers to consider in ensuring trans-inclusive care and treatment options: (1) Insurance Purchasing and Coverage, (2) ADAP Formulary Navigation, and (3) Collection of Sexual Orientation and Gender Identify Data.

Stigma, violence, barriers to employment and housing, and a history of negative interactions with structurally racist and transphobic institutions among other factors contribute to complex interactions with public providers today. As NASTAD calls to accelerate the end of HIV and Hepatitis, it is imperative we focus resources to those most disparately impacted by these epidemics. The need for transgender competency at the provider and health department-level is essential as the burden of HIV prevalence amongst transgender women persists at alarming and disparate rates. While prevention and outreach programs aim to target and recruit populations most affected by HIV, there exists a need to develop a core competency for systems and individuals to successfully engage trans populations in care.

For questions, more information about transgender health care considerations, or to request technical assistance, please contact Joe Caldwell and Kelsey Donnellan

Crossroads: ADAP Considerations For Transgender Health