Bottom Line: Transgender adults were more likely to report worse health-related quality of life compared with cisgender adults. This study used data from a large national health survey with an optional sexual orientation and gender identity module, which 36 U.S. states and territories used at least once from 2014 through 2017. The pooled data compared 3,075 transgender adults with about 719,000 cisgender adults. Transgender adults reported being less likely to have health insurance coverage and were more likely to report worse quality of life as measured by a greater likelihood of fair or poor health or severe mental distress. In addition, they reported more recent days of combined poor physical and mental health and activity limitations. The generalizability of these findings is limited because not all states and territories have used the survey's sexual orientation and gender identity module. The study suggests that all states and territories should use the module so that data from a truly nationwide sample of the transgender population can inform ongoing debates over public accommodations access, nondiscrimination protections and other issues that influence the health of transgender individuals.

Authors: Kellan E. Baker, M.P.H., M.A., of the Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland

(doi:10.1001/jamainternmed.2019.7931)

Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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