Demands for Health Care and Barriers to Health Care Access Among Transgender and Nonbinary People in Chile: A Nationwide Survey

Abstract

Purpose: This article reports the results of the first national survey carried out in Chile on health care for transgender and nonbinary people. Knowledge of their main demands for interventions, and of the barriers to care that they face, is currently lacking. We seek to address this gap and provide data useful to policymakers in improving care for this population. Methods: The survey was conducted between January 2021 and June 2022. The sample, consisting of 1116 participants, was recruited through social networks and transgender-rights organizations. Using chi-squared tests, statistically significant differences between items of interest and relevant sociodemographic information were identified. Data collected are reported based on frequencies (f) and percentages (%), and in contingency tables for the analysis of inter and intragroup variations. Results: Individual psychological attention (54.5%) and endocrinological follow-up (41%) were the interventions most received by the full sample. Of all treatments desired but not yet received, speech therapy headed the list (50.8%). Costs (74.2%), long waiting lists (34.6%), and insufficiently trained professionals (30.8%) were significant barriers to access. These percentages varied according to both participants' gender identity and area of residence. Conclusion: Provision for the care needs of the population surveyed was sparse. Differences in demands and access barriers were found between those declaring a female or male gender identity, and those whose identity was nonbinary or gender fluid, as well as between those enrolled in a public versus a private health system. These variations should be carefully weighed in developing effective trans and nonbinary health policies.