Initial Clinical Needs Among Transgender and Non-binary Individuals in a Large, Urban Gender Health Program

Background Transgender and gender-diverse individuals are particularly vulnerable to healthcare discrimination and related health sequelae. Objective To demonstrate diversity in demographics and explore variance in needs at the time of intake among patients seeking care at a large, urban gender health program. Design We present summary statistics of patient demographics, medical histories, and gender-affirming care needs stratified by gender identity and sexual orientation. Participants We reviewed all intake interviews with individuals seeking care in our gender health program from 2017 to 2020. Main Measures Clients reported all the types of care in which they were interested at the time of intake as their “reason for call” (i.e., establish primary care, hormone management, surgical services, fertility services, behavioral health, or other health concerns). Key Results Of 836 patients analyzed, 350 identified as trans women, 263 as trans men, and 223 as non-binary. The most prevalent sexual identity was straight among trans women (34%) and trans men (38%), whereas most (69%) non-binary individuals identified as pansexual or queer; only 3% of non-binary individuals identified as straight. Over half of patients reported primary care, hormone management, or surgical services as the primary reason for contacting our program. Straight, transgender women were more likely to report surgical services as their primary reason for contacting our program, whereas gay transgender men were more likely to report primary care as their reason. Conclusions Individuals contacting our gender health program to establish care were diverse in sexual orientation and gender-affirming care needs. Care needs varied with both gender identity and sexual orientation, but primary care, hormone management, and surgical services were high priorities across groups. Providers of gender-affirming care should inquire about sexual orientation and detailed treatment priorities, as trans and gender-diverse populations are not uniform in their treatment needs or goals.