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The Effect of Discrimination and Stigma on Health Care Access: Qualitative Research with Transgender Tennesseans

Buchman, Katherine Joan (2011) The Effect of Discrimination and Stigma on Health Care Access: Qualitative Research with Transgender Tennesseans. Master's Thesis, University of Pittsburgh. (Unpublished)

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The existing research suggests that the public health impact of discrimination and stigma against transgender individuals is to create significant barriers to health care for this population. Some studies suggest that rural LGBT populations experience more discrimination and different barriers to health care, but transgender health care experiences in rural locations have not been the primary focus of any public health research. This study explored the impact that discrimination and stigma has on the ability of rural and urban transgender individuals to access health care. Qualitative research was conducted using focus group discussions with self-identified transgender individuals in the Nashville and Knoxville regions of Tennessee. Four major themes emerged in the analysis of these discussions: (1) transgender individuals feel that health care providers' attitudes and behavior toward them belie a lack of personal respect and believe that their health care is compromised as a result; (2) transition health care is impeded because physicians and health insurance policies do not recognize gender transition as a medical necessity; (3) anti-trans discrimination in both rural and urban communities in Tennessee lead to expectations of similar treatment from health care providers; (4) and participants prioritized the need to increase the number of health care professionals who are well educated on transgender health concerns, as well as the roles of advocacy and social support in facilitating health care access. This study concluded that the medical education system must be improved to adequately prepare health care providers to provide appropriate health care to transgender patients. Health research is lacking in key areas of transgender health, including the implementation of a medical curriculum that successfully incorporates transgender health care, and there should be more funding opportunities for trans health research. Finally, the attitudes of health care providers can and should be addressed from within the health care profession through community advocacy for transgender patients' rights, and through trans-inclusive anti-discrimination laws that will carry legal consequences for providers who discriminate against transgender patients. The passage of laws such as the Employment Nondiscrimination Act currently sidelined in the Senate should be a priority.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Buchman, Katherine
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairGuadamuz, Thomasteg10@pitt.eduTEG10
Committee MemberLombardi, Emiliaell8@pitt.eduELL8
Committee MemberTerry, Marthamaterry@pitt.eduMATERRY
Committee MemberThomas, Tammytlthomas@pitt.eduTLTHOMAS
Date: 31 January 2011
Date Type: Completion
Defense Date: 16 December 2010
Approval Date: 31 January 2011
Submission Date: 30 November 2010
Access Restriction: 5 year -- Restrict access to University of Pittsburgh for a period of 5 years.
Institution: University of Pittsburgh
Schools and Programs: School of Public Health > Behavioral and Community Health Sciences
Degree: MPH - Master of Public Health
Thesis Type: Master's Thesis
Refereed: Yes
Uncontrolled Keywords: rural health; health care access; transgender
Other ID:, etd-11302010-210932
Date Deposited: 10 Nov 2011 20:07
Last Modified: 15 Nov 2016 13:52


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