June Leffler Published

Study: Health Care Barriers Exist For Transgender West Virginians


West Virginia University found that transgender people have a hard time accessing basic health care in the state, according to a study recently published in the International Journal of Environmental Research and Public Health. 

That goes for both primary care and gender-affirming care, which includes hormone therapies or surgeries to align patients’ bodies with their gender identities. Accessing this kind of care has been tied to improvements in one’s mental health, according to a review of 20 studies on the topic.

Researchers at WVU interviewed 24 transgender and gender non-conforming people (18 adults and six minors) throughout the state. On average, participants said they had to travel an hour and half to get gender-affirming care. Seventy percent said they had to go out of state.

Thirty-eight percent of participants said their insurance did not cover this kind of care. Just as many participants we’re sure if it was covered.

“We had a person who had been on their gender-affirming hormone treatment for 20 years, and they got a new insurance, and the new insurance said ‘We’re not going to let you take that medication until you’ve gone to therapy for a year’,” said Megan Gandy, an author of the study and professor at WVU’s School of Social Work. “Here’s this person who’s been on this treatment for more than half of their life now suddenly having to go off of it.”

Participants also said they’re reluctant to see the doctor for primary care needs because of past encounters where they were discriminated against.

“A transgender person with a broken foot, well, they shouldn’t be treated any differently than any other patient, and yet they do get treated differently,” Gandy said.

Practitioners might misgender someone, mistakenly or deliberate, or refer to patients by their “dead name” they no longer go by.

Interview participants even shared stories of having unnecessary, invasive testing.

“One of our study participants had abdominal pain, and because they were a transgender man, meaning they were assigned female at birth, the emergency room doctor said ‘We’re going to do a cervical workup’ when in fact it wasn’t related to that part of their body at all… and it ended up not being part of their actual treatment,” Gandy said.

Researchers say training health providers, from the receptionist to the physician, on how to approach transgender patients would go a long way. WVU and Fairness WV are already doing some of that work.

Hormone therapy is available in the state through Planned Parenthood, WVU and certain primary care doctors.

Findings from a 2016 UCLA study suggest less than a half percent of West Virginian adults, about 6,000 people, are transgender. The same researchers found one percent of teens in the state, about 1,000 people, are transgender.

Appalachia Health News is a project of West Virginia Public Broadcasting with support from Charleston Area Medical Center and Marshall Health.