A first-of-its-kind study of transgender health

For her study, Conron used the Massachusetts Behavioral Risk Factor Surveillance System, a telephone survey of randomly selected adults in the Commonwealth who voluntarily answer questions about their health. Starting in 2007, the survey began asking people if they considered themselves to be transgender, a term used to describe someone whose assigned sex at birth does not completely match their current gender identity. 

The findings were published online in the American Journal of Public Health on Thursday. Conron worked with researchers from the Massachusetts Transgender Political Coalition, BAGLY Inc. and John Snow Inc.

“My colleagues and I expected to find higher rates of unemployment and poverty and poorer health among transgender adults compared to non-transgender adults,” said Conron, who based the hypothesis on previous research on socially marginalized populations. “We were surprised to find that transgender adults reported health that is comparable to the non-transgender adult population, despite having higher rates of unemployment and poverty.” 

One exception, she added, was that researchers found higher rates of smoking among transgender adults, consistent with findings from another probability study in California. 

“We need make sure that tobacco prevention programming reaches transgender adolescents and that cessation services are available for transgender people,” Conron said.

Conron said that her study’s findings of employment disparities, which occur despite comparable levels of education and health between transgender and non-transgender adults, indicate the need for anti-discrimination laws to protect transgender people. Massachusetts Gov. Deval Patrick signed such legislation into law earlier this week. 

According to Conron, several factors might explain why transgender adults in Massachusetts are relatively healthy despite reduced work opportunities, including near-universal access to health care in the Commonwealth. 

“It is also important to remember that there is a sizable body of research showing that some segment of the transgender community has very poor health, including high rates of exposure to discrimination and violence victimization and the types of health problems that develop as a result of such experiences,” Conron said. “This means that our study may have reached a select group of people who were fortunate to be living in fairly stable households and who have better health because of their circumstances. A great deal more research is needed on transgender health, including studies to expand on our findings.”  

Conron said it is important for public health institutions to collect data and assess the health of the transgender population, as well as other marginalized groups. 

“Massachusetts is one of the first states in the country to collect information in the Behavioral Risk Factor Surveillance System about whether or not survey respondents are transgender, and we hope that our Department of Public Health will serve as a model for other states,” Conron said.

Provided by Northeastern University