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Does Discrimination Affect Whether Transgender People Avoid or Delay Healthcare?: A Nationwide Cross-sectional Survey in South Korea

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Abstract

This study examined the association between perceived discrimination and healthcare avoidance and delay (HAD) among transgender adults in South Korea (hereafter Korea). We conducted a nationwide cross-sectional survey of 244 Korean transgender adults in 2017. Discrimination within the last 12 months was categorized into four groups based on the reason(s) of discrimination experienced: (1) ‘never experienced' discrimination, (2) ‘only due to transgender identity,' (3) ‘due to reason(s) other than transgender identity,' and (4) ‘due to both transgender identity and other reason(s).' Korean transgender adults who experienced discrimination ‘only due to transgender identity’ and ‘due to both transgender identity and other reason(s)’ reported 1.91-times (95% CI 1.02–3.55) and 1.96-times (95% CI 1.32–2.92) higher prevalence of past 12-month HAD, respectively, than those who had no such experiences. Our findings suggest that institutional efforts are needed to protect transgender people from discrimination, which can contribute to improved access to healthcare among transgender populations in Korea.

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Acknowledgements

This study was funded by a Daum storyfunding project, “Our Transgender Health Study Journey Begins” and by Engineers and Scientists for Change as its first crowdfunding project. This work was also supported by the Ministry of Education of the Republic of Korea and the National Research Foundation of Korea (NRF-2020S1A5A2A01045197) and the Basic Science Research Program through the National Research Foundation of Korea funded by the Ministry of Education (2020R1A6A3A13060799). The authors would like to acknowledge the support of the professionals at the four healthcare institutions involved in data collection. In addition, the authors would like to acknowledge the Korean Transgender Rights Organization JOGAKBO and the numerous volunteer consultants for their help with survey questionnaire development as well as participant recruitment. We also appreciate the transgender individuals who participated in our study.

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Authors and Affiliations

  1. Department of Public Health Sciences, Graduate School of Korea University, Seoul, South Korea

    Hyemin Lee, Horim Yi, Sungsub Choo, Ji-Hwan Kim & Seung-Sup Kim

  2. Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA

    Hyemin Lee & Don Operario

  3. Interdisciplinary Program in Precision Public Health, Korea University, Seoul, South Korea

    Sungsub Choo & Seung-Sup Kim

  4. Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA

    Seung-Sup Kim

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  1. Hyemin Lee
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  2. Don Operario
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  3. Horim Yi
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  4. Sungsub Choo
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  5. Ji-Hwan Kim
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  6. Seung-Sup Kim
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Contributions

All authors have contributed significantly to the manuscript. Specifically, HL, DO, and SSK conceptualized the study; HL, HY and SSK collected the data; HL conducted the analysis and wrote manuscript in collaboration with DO and SSK; DO, HY, SC, JHK and SSK provided the feedback and suggestions.

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Correspondence to Seung-Sup Kim.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This study was approved by the institutional review board of Korea University (IRB No. 1040548-KU-IRB-17–67-A-1).

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Informed consent was obtained from all individual participants included in the study.

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Lee, H., Operario, D., Yi, H. et al. Does Discrimination Affect Whether Transgender People Avoid or Delay Healthcare?: A Nationwide Cross-sectional Survey in South Korea. J Immigrant Minority Health 24, 170–177 (2022). https://doi.org/10.1007/s10903-021-01193-9

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  • DOI: https://doi.org/10.1007/s10903-021-01193-9

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