Experiences of Health Care Discrimination Among Transgender and Gender Nonconforming People of Color: A Latent Class Analysis

There is a paucity of research on the within-group differences in experiences of health care discrimination among transgender and gender nonconforming people of color. This study employs latent class analysis to identify mutually exclusive subgroups of TGNC POC based on responses to measures of health care discrimination. The association between demographic and health indicators and subgroup membership was also examined. Four subgroups were found: the low discrimination subgroup marked by a low probability of endorsing any indicator; the experienced discrimination subgroup marked by a high probability of being denied treatment and having to teach one's provider about TGNC people to receive appropriate care; the anticipated discrimination subgroup characterized by a high probability of postponing care and having to teach one's provider about TGNC people; and the experienced and anticipated discrimination subgroup marked by a high probability of all discrimination indicators. The experienced discrimination subgroup was more likely to be comprised of participants who reported $40,000-$59,000 income range, had graduate degrees, were "out" as transgender and had undergone hormone treatment and bottom surgery; the anticipated discrimination subgroup was more likely to be comprised of participants who identified as transgender men, reported $40,000-$59,000 income range, and had undergone hormone treatment; and the experienced and anticipated discrimination subgroup was more likely to be comprised of participants who identified as transgender men, multiracial, had graduate degrees, had public insurance, were "out," and had undergone hormone treatment, top surgery, and bottom surgery. Our findings have implications for health care practice, policy, and practitioners' education. Public Significance Statement This study suggests that there are distinct subgroups of TGNC POC based on their reported experiences of discrimination in health care settings. There is also an association between demographic indicators and subgroup membership, which highlights the need to consider these factors to assess risk of discrimination and inform health care access improvements.