LATEBREAKER
Health Disparities
Measuring Health Trends of Transgender People Using Real World Data in The United States Theo Beltran* Theo Beltran Tonia Poteat Jennifer Lund Kathleen Thomas Shabbar Ranapurwala Brian Pence
Background
Due to the lack of standardized gender identity data in real-world data sources, researchers are unable to quantify mental health care trends among transgender people.
Objectives
We evaluate the performance of an existing computational phenotype (CP) in a claims database to identify transgender patients and assess the prevalence of mental health (depression and anxiety) and population trends over time.
Methods
We applied Jasuja et. al to establish a retrospective cohort of potential transgender patients from 2007 to 2021 using Merative MarketScan, a commercial insurance claims database. We measured trends over time for the total transgender population and sub-group with depression and anxiety using join-point regression.
Results
The Jasuja et. al CP identified 67,794 (0.2%) transgender patients from 2007 to 2021. The transgender population increased from 3 transgender patients per 100,000 enrollees in 2007 to 55 transgender patients per 100,000 enrollees in 2021. Gender identity related diagnoses increased from 45% in 2007 to 97% in 2021. Two join-points representing increases in TG patients in 2012 and 2017 with annual percentage changes (APC) of 44.6% (95% CI: 39.2, 55.9) and 22.5% (18.0, 26.3), respectively. 45.2%, 35.5%, and 55.7% of transgender patients were diagnosed with depression, anxiety, or both. One join-point in 2017 represented a 3.9% (-13.5, 2.1) APC declining trend among transgender patients diagnosed with psychiatric disorders.
Conclusion
The CP identified the largest transgender sample in commercial insurance claims data to date. Most TG patients were identified through gender identity related diagnoses which may be specific but not sensitive hence underestimating the true transgender population. Large increases in the total transgender patient population and among those with psychiatric disorders may represent an increase in access to insurance covered gender affirming services and the continued need to reduce burdens of psychiatric disorders.
