Developing a multidimensional healthcare access index for transgender individuals

Keywords: Healthcare access index, barriers, Quantitative methods, transgender people, India
Abstract Type: Paper Abstract

Abstract

Healthcare facilities have rigid heteronormative policies and practices, creating challenges for transgender individuals to access healthcare. This study aims to first, understand barriers to healthcare access, and second, identify spatial disparities in accessing healthcare among transgender individuals in Kolkata, India. To address these aims, quantitative and geospatial analyses were performed on survey data collected from 120 transgender individuals. A principal component analysis identified multidimensional factors impacting their healthcare access. A weighted average of the identified factors was then used to develop a robust healthcare access index. The index value was used to classify participants into three groups with high, moderate, and low access. The groups were then mapped to understand the spatial disparities in access to healthcare.
Findings showed six factors impacting a transgender individual’s access to healthcare: accessibility, accommodation, affordability, awareness, stigma/discrimination, and social capital. Spatial analysis indicated a disparity in healthcare access across the city. The participants from north Kolkata had low access to healthcare; experienced stigma/discrimination and low awareness as barriers to access due to their poor SES, sex-worker family background, and limited education. Whereas the participants from south Kolkata neighborhoods had moderate to high healthcare access with fewer barriers and much less stigma.
Compared to cisgender people, transgender individuals experience more stigma/discrimination when accessing healthcare, whereas awareness related barrier was at the intra-community level. The disparity in healthcare access among transgender individuals within the same city espouses the need for geospatial analysis highlighting the intersection of place and social determinants of health.