Table 4.
Logistic Regression Results Examining the Relationships Between Minority Stress Theory Components and Health Care Use Among Transgender and Other Gender Diverse Youth
| Difficulty accessing care (n=171) |
Used medical gender affirmation services (n=131) |
|||||
|---|---|---|---|---|---|---|
| Odds ratio | 95% CI | p | Odds ratio | 95% CI | p | |
| Main effects model results | ||||||
| Enacted stigma (Component 1)a | 1.03 | 0.70–1.52 | 0.884 | 1.04 | 0.64–1.68 | 0.867 |
| Positive sense of identity (Component 2)b | 1.12 | 0.82–1.53 | 0.475 | 1.73 | 1.15–2.59 | 0.008 |
| Social support (Component 3)c | 0.86 | 0.57–1.30 | 0.474 | 1.35 | 0.80–2.27 | 0.267 |
| Mis-gendering | 1.03 | 0.94–1.14 | 0.523 | 0.93 | 0.83–1.05 | 0.220 |
| Anticipated trans-related stigma | 0.99 | 0.95–1.05 | 0.904 | 0.92 | 0.86–0.98 | 0.012 |
| Age | 1.16 | 1.00–1.34 | 0.049 | 1.63 | 1.29–2.07 | <0.001 |
| Gender identity | ||||||
| Trans-feminine | Reference group | Reference group | ||||
| Trans-masculine | 1.96 | 0.63–6.13 | 0.247 | 1.02 | 0.31–3.41 | 0.967 |
| Other gender diverse (AMAB) | 0.82 | 0.18–3.60 | 0.788 | 0.07 | 0.005–0.99 | 0.049 |
| Other gender diverse (AFAB) | 1.81 | 0.54–6.02 | 0.334 | 0.08 | 0.01–0.47 | 0.005 |
| Race/ethnicity | ||||||
| Non-Hispanic white | Reference group | Reference group | ||||
| Racial minority | 1.85 | 0.86–3.99 | 0.115 | 0.78 | 0.27–2.21 | 0.635 |
| Region | ||||||
| Northeast | Reference group | Reference group | ||||
| Midwest | 1.45 | 0.44–4.77 | 0.540 | 0.24 | 0.05–1.03 | 0.055 |
| South | 1.15 | 0.36–3.73 | 0.810 | 0.21 | 0.05–0.84 | 0.028 |
| West | 1.23 | 0.35–4.40 | 0.745 | 1.06 | 0.26–4.35 | 0.940 |
| Health insurance | ||||||
| Does not have insurance coverage | Reference group | Reference group | ||||
| Has insurance coverage | 0.52 | 0.18–1.52 | 0.230 | 1.39 | 0.27–7.19 | 0.698 |
| Significant interaction term results | ||||||
| Enacted stigma (Component 1)×positive sense of identity (Component 2) | ||||||
| Enacted stigma quartile 1 | Reference group | |||||
| Enacted stigma quartile 2 | 1.79 | 0.70–4.58 | 0.222 | |||
| Enacted stigma quartile 3 | 1.53 | 0.60–3.90 | 0.378 | |||
| Enacted stigma quartile 4 | 4.35 | 1.53–12.38 | 0.006 | |||
Boldface indicates statistical significance (p < 0.05).
a
Component 1 comprised gender-related discrimination, gender-related victimization, and gender-related rejection.
b
Component 2 comprised internalized trans-related stigma (reversed), self-affirmation, and community connectedness.
c
Component 3 comprised social support.
CI, confidence interval.