Background : The objective of this paper is to assess access to care and health outcomes among TGNC people in the upper Midwest, an area frequently overlooked in research on trans health. The overall policy environment in the region is uneven, with only two states (Illinois and Minnesota) scoring “high” in terms of policies that support TGNC residents.
Methods : Using data from the 2015 U.S. Trans Survey, we used descriptive statistics to assess measures related to insurance access, provider competency, quality of care, and health outcomes. We used hierarchical linear regression analyses to compare intra- and inter-state differences between Wisconsin, Illinois, and Minnesota.
Results : Access to care and selected health outcomes are uneven in the region. As expected, unfavorable policy environments are predictive of insurance denials, traveling greater distance to see a competent provider, negative provider experiences, and poor health outcomes. Respondents in WI reported more denials in changing name/gender in records, hormones, and routine health care as well as higher suicide attempt rate.
Conclusions : This analysis demonstrates disparities in the upper Midwest related to access to care, quality of care, and health outcomes. Advocates, providers, and researchers can use these findings to push for state-level policy change to improve trans health in Wisconsin, in particular, to support ongoing litigation for inclusive insurance policies.