Table 1. Coding and description for study variables: Study populations, individual and state-level factors, seasonality, and health status outcomes.

Category	Variable	Coding and Description
Study populations	Study group	[1 = transgender woman (TW), 2 = transgender man (TM), 3 = gender nonbinary (GNB), 4 = cisgender men (CM), 5 = cisgender women (CW)] Do you consider yourself to be transgender? If yes, do you consider yourself to be: male-to-female, female-to-male, or gender nonconforming? If no, BRFSS surveyor determined sex by vocal timber.
Individual factors
Personal characteristics	Age	Age, in years. Range: 18–79, ≥80 (reference:a descending from oldest to youngest in regression models)
	Race/ethnicity	1 = White, NH; 2 = Black, NH; 3 = Hispanic; 4 = other race/ethnicity, NH (American Indian/Alaska Native; Asian only, NH; Native Hawaiian/other Pacific Islander only, non-NH; other race only, NH; or multiracial, NH)
	Racial/ethnic minority	1 = racial/ethnic minority, 0 = racial/ethnic majority (reference) Racial/ethnic minority = Black, NH; Hispanic; other race/ethnicity. Racial/ethnic majority = White, NH
	Geographic classification	[0 = suppressed, 1 = not in MSA, 2 = in MSA] BRFSS used participant zip code to determine if in/out of a MSA, or BRFSS suppressed for participant confidentiality.
	Sexual orientation	[1 = straight/heterosexual, 2 = lesbian or gay, 3 = bisexual, 4 = other, 5 = don’t know/not sure] Do you consider yourself to be: straight, lesbian or gay, bisexual, other, or don’t know/not sure?
	Sexual minority	1 = lesbian or gay, bisexual, other, and don’t know/not sure; 0 = heterosexual (reference)
	Marital status	1 = married, 2 = divorced, 3 = widowed, 4 = separated, 5 = never married, 6 = member of an unmarried couple
	Unmarried	1 = divorced, widowed, separated, never married, 0 = married and member of an unmarried couple (reference)
Socioeconomic position	Educational attainment	[1 = some high school or less, 2 = high school/GED graduate, 3 = some college, 4 = college graduate] Highest grade or year of school completed.
	High school graduate or less	1 = high school/GED graduate or less, 0 = some college or college graduate (reference)
	Employment status	1 = employed for wages/self-employed, 2 = out of work, 3 = homemaker, 4 = student, 5 = retired, 6 = unable to work
	Not working	1 = out of work, homemaker, student, retired, unable to work; 0 = employed, (reference)
	Annual household income	[1 = <$20K, 2 = $20K to <$50K, 3 = ≥$50K] Annual household income from all sources.
	Low income	1 = <$20K 0 = ≥$20k (reference)
	Health insurance status	[1 = yes, 0 = no] Do you have any kind of health care coverage, including health insurance, prepaid plans such as HMOs, government plans such as Medicare, or Indian Health Service?
	Uninsured	1 = yes, 0 = no (reference)
State-level factor	Discriminatory laws/policiesb	[1 = yes, 0 = no (reference)] Does state have any laws or policies that harm or deliberately targets transgender people?
	Percent voting Republicanc	[Range: 27.84%–62.30%] Proportion of voters who voted for the Republican candidate in the U.S. 2012 presidential election.
Seasonality	Winter/Fall	[1 = yes, 0 = no (reference)] BRFSS data collection occurred during Winter/Fall (September–February).
Health status outcomes
Self-rated general health	Fair/poor health	[1 = fair or poor self-rated general health, 0 = excellent, very good, or good self-rated health] Would you say your general health is excellent, very good, good, fair, or poor?
Health-related quality of life	Physical unhealthy days	Range: 0–30 days. Thinking about your physical health, which includes physical illness and injury, for how many days during the past 30 days was your physical health not good?
	Frequent physical unhealthy days	1 = ≥5 physical unhealthy days during the past 30 days, 0 = 0–5 days
	Mental unhealthy days	Range: 0–30 days. Thinking about your mental health, which includes stress, depression, and problems with emotions, for how many days during the past 30 days was your mental health not good?
	Frequent mental unhealthy days	1 = ≥5 mental unhealthy days during the past 30 days, 0 = 0–5 days
Chronic health conditionsd	≥2 chronic health conditions	[1 = ≥2 chronic health conditions, 0 = <2 chronic health conditions] Based on the following 9 individual chronic health conditions: heart disease (heart attack/myocardial infarction, angina, or coronary health disease); kidney disease, diabetes; COPD, emphysema, or chronic bronchitis; asthma; stroke; cancer (skin and any other type of cancer); a form of arthritis, rheumatoid arthritis, gout, lupus, or fibromyalgia; or a depressive disorder including depression, major depression, dysthymia, or minor depression
Health problems or impairments	≥ 3 health problems or impairments	[1 = ≥3 health problems or impairments, 0 = <3 health problems or impairments] Based on the following 7 individual health problems or impairments: limited in any way in any activities because of physical, mental, or emotional problems; uses special equipment (cane, a wheelchair, special bed, or special telephone);blind or have serious difficulty seeing, even with glasses; serious difficulty walking or climbing; difficulty dressing or bathing; serious difficulty concentrating, remembering, or making decisions because of a physical, mental, or emotional condition; or difficulty doing errands alone because of a physical, mental, or emotional condition

Description of variables provided in italics. Bold items represent key study measures used in analytic models. BRFSS: Behavioral Risk Factor Surveillance System; COPD: Chronic Obstructive Pulmonary Disease; MSA: Metropolitan Status Area; NH: Non-Hispanic.

^aReference = reference group for the logistic regression models.

^bDiscriminatory laws/policies from Movement Advancement Project.

^cPercentage voting Republican data from the Federal Election Commission.

^dBRFSS participants are asked if a doctor, nurse, or other health professional had ever told them that they had the chronic health condition.