Chronic conditions among transgender Medicare beneficiaries: Variation by race, ethnicity, and Medicaid dual-enrollment.
Gray Babbs, Abby Mulcahy, Jacqueline Ellison and 6 others
PMID 39701841WHAT IT FOUND
Transgender adults on disability Medicare have very high rates of chronic conditions, especially those also on Medicaid.
Mental health and cardiovascular issues affect over 80% of this group. Clinicians should expect complex, overlapping health needs rather than isolated conditions.
Key findings
01Dual-eligible transgender beneficiaries had significantly higher predicted probabilities for 9 out of 10 chronic condition categories compared to Medicare-only beneficiaries.
02Mental health and cardiovascular conditions were the most prevalent categories, affecting over 85% of dual-eligible beneficiaries.
03Over half of dual-eligible beneficiaries had at least five concurrent chronic conditions, indicating a high burden of multimorbidity.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study only included people who qualified for Medicare based on disability, so it does not represent all transgender adults with disabilities, particularly those who do not meet the strict work-limitation criteria. Gender identity was inferred from claims data rather than self-reported, which may miss individuals who do not access gender-affirming care. Chronic conditions were identified through healthcare utilization, meaning conditions that are underdiagnosed or not treated may be underestimated. The analysis excluded Asian, Pacific Islander, American Indian, and Alaska Native beneficiaries due to small sample sizes, limiting generalizability across all racial and ethnic groups.
Declared interests
No specific conflicts of interest or funding sources were stated in the provided text.
The easy way to misread this
Do not assume these rates apply to all transgender adults with disabilities. This study only looked at those who qualified for Medicare based on disability, which requires a severe enough condition to prevent working. Patients with less severe disabilities or different insurance are not represented here.