Table 3.
Cox Regression of Factors Associated with Time to Receiving Gender-Affirming Care Among Transgender and Nonbinary Youth Aged 13–20 Years Seeking Care at Seattle Children's Hospital Gender Clinic, 2017–2018
| Characteristics | Time from contacting clinic to completing phone intake |
Time from completing intake to first medical appointment |
Time from first medical appointment to receiving PBs/GAHs |
|||
|---|---|---|---|---|---|---|
| Univariate, HR (95% CI) | Multivariate, aHR (95% CI) | Univariate, HR (95% CI) | Multivariate, aHR (95% CI) | Univariate, HR (95% CI) | Multivariate, aHR (95% CI) | |
| Gender and sex assigned at birth | ||||||
| Transmasculine or nonbinary AFAB | Ref. | Ref. | Ref. | Ref. | Ref. | Ref. |
| Transfeminine or nonbinary AMAB | 1.22 (0.78–1.91) | 1.08 (0.65–1.81) | 1.05 (0.68–1.63) | 1.24 (0.75–2.07) | 0.67 (0.37–1.21) | 0.55 (0.28–1.11) |
| Race/ethnicity | ||||||
| White | Ref. | Ref. | Ref. | Ref. | Ref. | Ref. |
| Asian, Black, Latinx, or Native American | 0.84 (0.53–1.33) | 0.83 (0.49–1.39) | 0.82 (0.52–1.28) | 0.80 (0.50–1.29) | 1.14 (0.63–2.06) | 1.12 (0.58–2.15) |
| Age (years) | ||||||
| 13–14 | Ref. | Ref. | Ref. | Ref. | Ref. | Ref. |
| 15–17 | 0.39 (0.23–0.65) | 0.32 (0.17–0.60) | 0.37 (0.23–0.60) | 0.49 (0.29–0.85) | 1.10 (0.59–2.08) | 1.04 (0.49–2.21) |
| 18–20 | 0.55 (0.26–1.13) | 0.86 (0.24–3.01) | 0.22 (0.10–0.45) | 0.12 (0.04–0.40) | 0.96 (0.37–2.53) | 2.43 (0.35–16.91) |
| Caregiver income | ||||||
| >$50,000 | Ref. | Ref. | Ref. | Ref. | Ref. | Ref. |
| <$50,000 | 0.56 (0.34–0.92) | 1.52 (0.71–3.27) | 0.40 (0.24–0.68) | 0.42 (0.21–0.82) | 0.95 (0.52–1.73) | 1.02 (0.40–2.59) |
| Insurance type | ||||||
| Private | Ref. | Ref. | Ref. | Ref. | Ref. | Ref. |
| Medicaid | 0.50 (0.31–0.80) | 0.31 (0.14–0.68) | 0.71 (0.45–1.11) | 1.20 (0.69–2.09) | 0.74 (0.41–1.34) | 0.79 (0.35–1.78) |
| No insurance | 0.54 (0.24–1.21) | 1.09 (0.28–4.30) | 0.57 (0.26–1.25) | 0.90 (0.22–3.63) | 1.42 (0.50–4.03) | 6.20 (0.57–67.28) |
| Tension with caregivers about gender | ||||||
| No | Ref. | Ref. | Ref. | Ref. | Ref. | Ref. |
| Yes | 0.64 (0.42–0.99) | 0.69 (0.43–1.11) | 0.74 (0.49–1.13) | 1.06 (0.65–1.72) | 0.99 (0.58–1.70) | 0.93 (0.47–1.84) |
| Driving distance from home to clinic (miles) | ||||||
| <25 | Ref. | Ref. | Ref. | Ref. | Ref. | Ref. |
| >25 | 0.79 (0.52–1.20) | 1.32 (0.79–2.21) | 0.76 (0.51–1.14) | 0.88 (0.56–1.40) | 0.96 (0.57–1.62) | 1.04 (0.56–1.92) |
| Timing of mental health assessment | ||||||
| Before first appointment | Ref. | Ref. | ||||
| After first appointment | 0.62 (0.34–1.12) | 0.44 (0.22–0.88) | ||||
| Not applicable, age 18+ | 0.72 (0.35–1.52) | 0.34 (0.10–1.14) | ||||
Bolded numbers indicate statistically significant estimates with 95% CI that do not contain 1.0.
aHR, adjusted hazard ratio; CI, confidence interval; HR, hazard ratio.