CHSE wins funds to study care for transgender patients in Oregon Medicaid

08/22/18  Portland, Ore.

Award supplements larger research effort on how Medicaid reform impacts health-care disparities

The National Institutes of Health (NIH) has awarded CHSE $99,604 to assess the ways in which health and health care disparities in Oregon’s transgender population are affected by Medicaid reform -- the first NIH award to address this topic in Oregon.

The project is an administrative supplement to CHSE’s existing NIH grant looking at impacts of Oregon Medicaid reform on health care disparities among racial and ethnic minority groups.  

The new project will extend this work to look at effects of Oregon’s Medicaid policy changes on disparities experienced by transgender people. In January 2015, Oregon's Medicaid program became the second in the country to explicitly cover transition-related services for the transgender community.

Evidence indicates that transgender people experience poorer general, physical, and mental health compared to cisgender people. Transgender people report high rates of postponing needed medical care, citing access to providers knowledgeable about transgender health needs as barriers to care.

Oregon began covering treatments related to gender dysphoria and gender identity disorder in its Medicaid program in order to address differentially higher rates of depression, anxiety, and suicidality in the transgender community.

In addition to looking at general health care access, CHSE will evaluate and describe whether Oregon’s coverage of transition-related care meaningfully affects use of these services by transgender Oregonians. Services to be studied include hormone therapy, puberty blockers, mastectomy and chest reconstruction, mastopexy and breast reconstruction, and urethroplasty/urethral reconstruction. 

Using Medicaid claims from 2010-2017, CHSE will evaluate whether the implementation of Medicaid coverage for transition-related care affected service usage as well as access to primary and preventative care. The study team will also analyze data to enumerate how many transgender people may potentially benefit from this reform.

The deep-dive evaluation will provide critical information into the effectiveness of Oregon’s Medicaid coverage reform at addressing disparities for transgender people.