PSU Professor of Epidemiology Alexis Dinno speaks at the Transgender Health Panel held at PSU. Alex Wittwer/PSU Vanguard

The Future of Transgender Healthcare

 LGBTQ+ leaders in public health discuss research reform, transgender health needs 

Portland State, in collaboration with Oregon Health & Science University, held a forum on Oct. 18 to discuss healthcare obstacles transgender and gender diverse people face and the efforts to solve them.

The forum was made up of LGBTQ+ leaders in public health who are making changes and maintaining progress not only in the way they gather data but the way care is provided.

“There has been little to no public health surveillance of transgender populations in the United States,” said Alexis Dinno, a professor of epidemiology for OHSU and PSU. “So those questions of population health and mortality cannot be answered with the precision we give to cisgender people.” 

Transgender and gender diverse people often have been studied in research designed for cisgender people. This means the impact of survey data which misrepresents gender through limited options can potentially have vast and unforeseeable consequences.

Dinno encourages understanding of the difference between gender and sex and said the concepts should be segregated not only in daily life but in the methods in which populations are studied. 

“Divorcing gender from any imperative of sex productively liberates a human being’s potential,” Dinno said. 

Jae Downing, a professor at the OHSU-PSU School of Public Health, posed the question of how LGBTQ+ people can avoid being erased in research. 

“We need research that is reflective of all of our health needs beyond just HIV—one of the primary health needs asked for in our community is access to gender-affirming care,” Downing said. 

Gender-affirming care can refer to many different types of care gender diverse people seek out, including hormone therapy and surgery. 

“We still don’t quite know what the level of demand is for services,” Downing said. “In fact, most gender-affirming surgeries are paid for out of pocket, which means those who can’t pay go without care.”

Medicare is the largest health insurance program in the nation. However, Medicare only covers gender-affirming care in some states, including Oregon.

According to an Oregon Healthy Teens survey of eighth graders, gender diverse teens are three times more likely to commit suicide. 

“There is nothing about being a gender diverse teen that means you have to feel like this,” said Julia Przedworski, a senior research associate at OHSU. “This is not part of a gender diverse experience.”