Transgender, Gender Nonbinary Medicare Beneficiaries Have Greater Disability, Mental Health Burdens

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Gender minority Medicare beneficiaries such as transgender, or gender nonbinary individuals have greater disability and mental health burdens.

HealthDay News — Gender minority Medicare beneficiaries have larger disability and mental health burdens than the general Medicare population, according to a study published online in Health Affairs.

Ana M. Progovac, PhD, from Cambridge Health Alliance in Massachusetts, and colleagues identified gender minority (transgender or gender-nonbinary) Medicare beneficiaries using diagnosis codes and compared them to a 5% random sample of nongender minority Medicare beneficiaries from 2009 to 2014. Comparisons were assessed for mental health and chronic diseases, use of preventive and mental health care, hospitalizations, and emergency department visits.

The researchers found that gender minority beneficiaries experienced more disability and mental illness, and, after adjustment for age and mental health, they used more mental health care. They were also more likely to be hospitalized and to visit the emergency department after adjustment for age and chronic disease. Findings were similar for both disabled and older cohorts.

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“Higher rates of emergency care use among gender minority than nongender minority beneficiaries may signal relatively higher unmet need and highlight the need for more action to study and mitigate potential drivers of morbidity for this population,” the authors write.


Progovac AM, Cook BL, Mullin BO, et al. Identifying gender minority patients’ health and health care needs in administrative claims data. Health Aff (Millwood). 2018;37(3):413-420.