Estimating the Health Status of Privately Insured Gender Minority Children and Adults

• Published in: LGBT health Vol. 6; no. 6; p. 289
• Main Authors: McDowell, Alex, Progovac, Ana M, Cook, Benjamin Lê, Rose, Sherri
• Format: Journal Article
• Language: English
• Published: United States 01.09.2019
• Subjects: insurance claims; gender minority; health disparities; health policy; mental health; transgender
• ISSN: 2325-8306
• DOI: 10.1089/lgbt.2018.0238

The purpose of this study was to characterize the health status of privately insured gender minority individuals. We created a diagnosis-based algorithm to identify gender minority children and adults in the 2009-2015 IBM MarketScan Commercial Database. We compared the age-adjusted health status among individuals with and without gender minority-related diagnosis codes. The percentage of the privately insured population with gender minority-related diagnosis codes increased from 0.004% in 2009 to 0.026% in 2015. Age-adjusted analyses demonstrated that individuals with gender minority-related diagnosis codes were more likely to have diagnoses for mental health disorders (odds ratio [OR] = 8.5; 95% confidence interval [CI] = 8.1-9.0), substance use disorders (OR = 3.4; 95% CI = 2.9-3.9), and diabetes (OR = 1.4; 95% CI = 1.2-1.6), driven by high prevalence of these conditions among individuals younger than 18 years. Our findings highlight a markedly greater prevalence of mental health and substance use disorder diagnoses among privately insured gender minority individuals. These results establish a reference point for evaluating the impact of federal- and state-level policies that ban health insurance discrimination based on gender identity on the health and health care use of gender minority individuals.