abstract: 'This propensity-matched analysis utilized the publicly available

  Behavioral Risk Factor Surveillance System (2017-2019) data to compare

  the burden of disabilities among transgender/non-binary (TGNB) and

  cisgender groups. The groups were matched (1:1 ratio) on demographic

  variables using Nearest Neighborhood Matching. Categorical variables

  were compared among groups using a Chi-square analysis to test

  differences in the proportions. Multivariate logistic regression

  analysis was fit to predict the likelihood of the physical and mental

  disabilities among the TGNB group compared with the cisgender group

  while controlling for healthcare access factors, income, and employment.

  Survey weights were included in the model to account for the complex

  survey design. In a weighted sample of 664,103 respondents, only 2827

  (0.4\%) self-identified as TGNB. In the matched sample, a higher

  proportion of the TGNB group belonged to the low-income group (39.5\%

  vs. 29.8\%, p < 0.001), were unable to work (12.5\% vs. 8.6\%, p <

  0.001), and delayed care due to cost barriers (19.0\% vs. 12.4\%, p <

  0.001). Compared with the cisgender group, the odds of having difficulty

  making decisions were 1.94 times higher (95\% CI: 1.67-2.27) and odds of

  difficulty walking were 1.38 times higher (95\% CI: 1.19, 1.59) among

  the TGNB group. Additionally, the TGNB group had 59.8\% higher adjusted

  odds ratio (aOR) (aOR 1.598, 95\% Confidence interval (CI): 1.256,

  2.034) of experiencing difficulty dressing and 83.3\% higher odds (aOR

  1.833, 95\% CI: 1.533, 2.191) in having difficulty doing things alone.

  The findings of this study advocate for developing policies and

  interventions to deliver culturally competent care to the TGNB

  population with disabilities.'
affiliation: 'Pharr, JR (Corresponding Author), Univ Nevada, Sch Publ Hlth, Dept Environm
  \& Occupat Hlth, Las Vegas, NV 89119 USA.

  Pharr, Jennifer R., Univ Nevada, Sch Publ Hlth, Dept Environm \& Occupat Hlth, Las
  Vegas, NV 89119 USA.

  Batra, Kavita, Univ Nevada, Kirk Kerkorian Sch Med, Off Res, Las Vegas, NV 89102
  USA.'
article-number: '1285'
author: Pharr, Jennifer R. and Batra, Kavita
author-email: 'jennifer.pharr@unlv.edu

  Kavita.batra@unlv.edu'
author_list:
- family: Pharr
  given: Jennifer R.
- family: Batra
  given: Kavita
da: '2023-09-28'
doi: 10.3390/healthcare9101285
eissn: 2227-9032
files: []
journal: HEALTHCARE
keywords: 'physical disability; mental disability; transgender; propensity score

  matching; Behavioral Risk Factor Surveillance System'
keywords-plus: 'KEY HEALTH INDICATORS; UNITED-STATES; OLDER-ADULTS; MINORITY STRESS;

  CARE ACCESS; US ADULTS; GAY; STIGMA; PREJUDICE; CANCER'
language: English
month: OCT
number: '10'
number-of-cited-references: '61'
orcid-numbers: 'Batra, Kavita/0000-0002-0722-0191

  Pharr, Jennifer/0000-0002-0383-2641'
papis_id: f86864306f3c18b8f9cf58c2e00cc585
ref: Pharr2021physicalmental
researcherid-numbers: 'Batra, Kavita/ABH-7821-2020

  '
times-cited: '2'
title: 'Physical and Mental Disabilities among the Gender-Diverse Population Using
  the Behavioral Risk Factor Surveillance System, BRFSS (2017-2019): A Propensity-Matched
  Analysis'
type: article
unique-id: WOS:000726352200001
usage-count-last-180-days: '0'
usage-count-since-2013: '2'
volume: '9'
web-of-science-categories: Health Care Sciences \& Services; Health Policy \& Services
year: '2021'