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Transgender people seen in ER more likely than cisgender people to be admitted to hospital

Transgender individuals’ emergency department visits are 52.4% more likely to result in hospital admittance, and they are often more ill when they show up to ERs.

Photo by @cottonbro from Pexels.com

Transgender people who come to the emergency room for care tend to be sicker than cisgender people who are otherwise similar to them, and are much more likely to be admitted to the hospital once they visit the ER.

This is according to researchers at the University of Michigan in Ann Arbor after they analyzed information on 66,382 ER visits by transgender patients between 2006 and 2018 from the Nationwide Emergency Department Sample database. Data were adjusted for payment, age group, region, income and mental health conditions. 

More than 1.6 million people over the age of 13 in the US alone are transgender and gender diverse. Because of social discrimination, they face many difficulties getting the health care they need, said lead researcher Daphna Stroumsa, M.D., M.P.H.

Here are the major findings of the study: 

  • Transgender individuals’ emergency department visits are 52.4% more likely to result in hospital admittance, and they are often more ill when they show up to ERs than their cisgender counterparts.
  • 58.2% of ED visits made by transgender individuals were related to chronic conditions compared to 19.2% for cisgender patients.
  • 28.7% of transgender patients visiting an ED had a mental health condition, compared to 3.9% for cisgender patients.
  • Hospital admittance following an ED visit for a chronic condition concern was likely to occur for 67.3% of transgender patients, and 41.3% for cisgender patients.
     
  • Hospital admittance following an ED visit for a mental health concern was likely to occur for 37.2% of transgender individuals compared to just 5.3% for cisgender people.

“The high admission rates, and the high proportion of transgender and gender-diverse people with a chronic condition or with mental health condition, may represent worse overall health due lack of primary care, or a delay in seeking emergency care among transgender and gender-diverse people,” Stroumsa said. “Discrimination and transphobia have direct consequences, worsen the health of transgender people, and lead to poor use of health care resources. There is a need for increasing access to affirming primary and mental health care among transgender and gender-diverse people.”

The findings suggest that decreasing discrimination against transgender people in society and in health care, and improving the outpatient care they are able to access in the community, may keep them healthier and help them avoid visits to the ER, stressed Stroumsa. And so “improving access to transgender-friendly health care can improve the health of this population, and help decrease the burden on emergency rooms and hospitals.”

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