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Examining transgender health through the International Classification of Functioning, Disability, and Health’s (ICF) Contextual Factors

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Abstract

Purpose

For many transgender individuals, medical intervention is necessary to live as their desired gender. However, little is known about Contextual Factors (i.e., Environmental and Personal) that may act as facilitators and barriers in the health of transgender individuals. Therefore, this paper sought to examine Contextual Factors of the World Health Organization’s International Classification of Functioning, Disability, and Health that may facilitate or negatively impact the physical, psychological, and social functioning of transgender individuals.

Methods

A literature review was conducted to identify Environmental and Personal Factors that may influence transgender individuals’ physical, psychological, and social functioning. Seven electronic databases were searched. In total, 154 records were reviewed, and 41 articles and other records met inclusion criteria.

Results

Three general themes emerged for Environmental Factors: family and social networks, education, and health care. Three general themes also emerged for Personal Factors: socioeconomic status, race, and age.

Conclusions

Transgender individuals benefit from gender-affirming services, improved family and social support systems, and competent provider care. Educational training programs, including medical curricula or workshops, might provide the greatest benefit in improving transgender health by increasing the knowledge and cultural competency of health professionals working with this population. Given the diversity of gender expression, differences in lived experiences, and potential for enduring persistent "double discrimination" due to the intersectional relationships between socioeconomic status, race, and/or age, health professionals must approach transgender health using a holistic lens such as the World Health Organization’s International Classification of Functioning, Disability, and Health.

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Acknowledgements

We would like to acknowledge the assistance of Dr. Jack Pickering, College of Saint Rose, Albany, NY, and Dr. Laura Brumariu, Adelphi University, Garden City, NY for providing invaluable insight on this important topic. The authors thank Kevin Grandfield, an independent medical editor, for editorial assistance.

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Authors and Affiliations

  1. Undergraduate Program in Communication Disorders, Adelphi University, Garden City, NY, 11530, USA

    Melissa Jacob

  2. Voice and Quality of Life Laboratory, Adelphi University, Garden City, NY, 11530, USA

    Melissa Jacob & Steven R. Cox

  3. Department of Communication Sciences and Disorders, Hy Weinberg Center, Adelphi University, Garden City, NY, 11530, USA

    Steven R. Cox

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  1. Melissa Jacob
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Correspondence to Steven R. Cox.

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Melissa Jacob declares that she has no conflict of interest. Steven Cox declares that he has no conflict of interest.

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This article does not contain any studies with human participants or animals performed by any of the authors.

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Jacob, M., Cox, S.R. Examining transgender health through the International Classification of Functioning, Disability, and Health’s (ICF) Contextual Factors. Qual Life Res 26, 3177–3185 (2017). https://doi.org/10.1007/s11136-017-1656-8

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