Alex McDowell1,2, Ana M Progovac3,4, Benjamin Lê Cook3,4, Sherri Rose2. 1. PhD Program in Health Policy, Harvard University, Cambridge, Massachusetts. 2. Department of Health Care Policy and Harvard Medical School, Boston, Massachusetts. 3. Department of Psychiatry, Harvard Medical School, Boston, Massachusetts. 4. Health Equity Research Lab, Department of Psychiatry, Cambridge Health Alliance, Cambridge, Massachusetts.
Abstract
Purpose: The purpose of this study was to characterize the health status of privately insured gender minority individuals. Methods: 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. Results: 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. Conclusions: 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.
Purpose: The purpose of this study was to characterize the health status of privately insured gender minority individuals. Methods: 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. Results: 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. Conclusions: 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.
Entities:
Keywords:
gender minority; health disparities; health policy; insurance claims; mental health; transgender
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