ArticleBMC public health2023
The significance of structural stigma towards transgender people in health care encounters across Europe: Health care access, gender identity disclosure, and discrimination in health care as a function of national legislation and public attitudes.
Article in BMC public health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers.
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Who cites it
28 citing papers in PubMed.
- Moderating effects of coping strategies on the associations between stigma and depression among emerging adults.Journal of affective disorders · 2025Trial
- Beyond the Individual: The Weight of Social and Structural Determinants of Depression Among Transgender Women Living with HIV in France (ANRS-Trans&HIV).AIDS and behavior · 2026Observational
- Monitoring the HIV response for trans people in Europe and Central Asia.HIV medicine · 2026Article
- Urological care for sexual and gender minorities: a narrative review toward equitable care.Current opinion in urology · 2026Review
- Structural Cissexism, Mental Health, and Unmet Health Care Needs Among Gender-Diverse Adolescents in the United States.American journal of public health · 2026Article
- Denial of access to sexual and reproductive health services in Europe: an analysis of cases from the European court of human rights (1976-2023).Reproductive health · 2026Article
- Article
- Anxiety symptoms and self-reported executive functioning in transgender and gender nonconforming adults: associations with autistic traits and depression.Frontiers in psychology · 2026Article
- Which transgender and gender diverse groups benefit most from E-health? Subgroup analyses of the randomized controlled trial iInternational journal of transgender health · 2026Article
- Gender-affirming health care needs, barriers to care, and health and wellbeing in a broad nationwide sample of transgender people in Norway.BMC public health · 2025Article
- Inequities in HIV prevention among trans and/or non-binary people: a cross-sectional survey analysis of PrEP and PEP awareness and use in Spain.International journal for equity in health · 2025Article
- Perceived Stigma and Quality of Life in Binary and Nonbinary/Queer Transgender Individuals in Italy: The Mediating Roles of Patient-Provider Relationship Quality and Barriers to Care.European journal of investigation in health, psychology and education · 2025Article
- Toward an understanding of sexual minority women's social stressors and health in post-communist countries in Europe: a scoping review.BMC public health · 2025Article
- Psychometric properties of the genderism and transphobia scale in Iranian students.Health promotion perspectives · 2025Article
- Gender Minority Stressors, Hopelessness, and Their Associations with Internalizing and Externalizing Mental Health Outcomes in a Hungarian Trans Adult Sample.Archives of sexual behavior · 2025Article
- Gender identity and its impact on attention deficit hyperactivity disorder manifestations: Challenges in diagnosis and assessment.World journal of psychiatry · 2025Review
- Characteristics of non-suicidal self-injury and its associations with gender minority stressors among Hungarian transgender and gender diverse adults.BMC psychiatry · 2025Article
- "Saying 'I'm not okay' is extremely risky": Postpartum mental health, delayed help-seeking, and fears of the child welfare system among queer parents.Family process · 2025Article
- Socioecological Predictors of Resilience in Sexual and Gender Minority Individuals.Journal of community health · 2025Article
- Relationships between structural stigma, societal stigma, and minority stress among gender minority people.Scientific reports · 2025Article
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Authors and funding
2 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundAccording to the minority stress theory, stigma affects the health of marginalized populations. Previous stigma research has focused on the health effects of individual and interpersonal stigma, paying less attention to structural factors. Laws on legal gender recognition affect the lives of transgender individuals in unique ways. The fact that these laws and population attitudes vary greatly between European countries, offer a unique opportunity to study the role of structural stigma in the lives of transgender individuals. Little is known about how transgender specific structural stigma relates to individual health determinants. Consequently, the aim of this study was to explore the association between structural stigma and access to gender affirming care, gender identity disclosure in health care, and experiences of discrimination in health care across 28 European countries.
methodsBy using multilevel regression, we combined data on health seeking behavior, transgender identity disclosure to health care providers, and experiences of discrimination in health care from 6,771 transgender individuals participating in the 2012 European Union Lesbian, Gay, Bisexual and Transgender survey with a structural stigma measure, consisting of population attitudes towards transgender individuals as well as national legislation on gender recognition. Reasons to refrain from seeking care and discrimination in health care were assessed by categorizing countries as low or high in structural stigma and using Chi-square statistics.
resultsCountry-level structural stigma was negatively associated experiences of seeking gender affirming care and positively associated with concealment of being transgender to health care providers. Identity concealment was associated with a lower likelihood of exposure to discrimination in the health care setting across countries regardless of their level of structural stigma. The most prevalent reasons to forgo gender affirming care were shared between low and high structural stigma country groups and centered around fear.
conclusionThe results highlight the importance of changing stigmatizing legislation and population attitudes to promote access to gender affirming care as well as openness of being transgender towards providers. Measures to decrease discrimination in the health care setting are warranted in high as well as in low structural stigma countries.
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