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      Differences in All-Cause Mortality Among Transgender and Non-Transgender People Enrolled in Private Insurance

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          Abstract

          Few studies have analyzed mortality rates among transgender (trans) populations in the United States and compared them to the rates of non-trans populations. Using private insurance data from 2011 to 2019, we estimated age-specific all-cause mortality rates among a subset of trans people enrolled in private insurance and compared them to a 10% randomly selected non-trans cohort. Overall, we found that trans people were nearly twice as likely to die over the period as their non-trans counterparts. When stratifying by gender, we found key disparities within trans populations, with people on the trans feminine to nonbinary spectrum being at the greatest risk of mortality compared to non-trans males and females. While we found that people on the trans masculine to nonbinary spectrum were at a similar risk of overall mortality compared to non-trans females, their overall mortality rate was statistically smaller than that of non-trans males. These findings provide evidence that some trans and non-trans populations experience substantially different mortality conditions across the life course and necessitate further study.

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          Most cited references86

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          Standards of Care for the Health of Transsexual, Transgender, and Gender-Nonconforming People, Version 7

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            Doing Gender

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              Stigma as a fundamental cause of population health inequalities.

              Bodies of research pertaining to specific stigmatized statuses have typically developed in separate domains and have focused on single outcomes at 1 level of analysis, thereby obscuring the full significance of stigma as a fundamental driver of population health. Here we provide illustrative evidence on the health consequences of stigma and present a conceptual framework describing the psychological and structural pathways through which stigma influences health. Because of its pervasiveness, its disruption of multiple life domains (e.g., resources, social relationships, and coping behaviors), and its corrosive impact on the health of populations, stigma should be considered alongside the other major organizing concepts for research on social determinants of population health.
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                Author and article information

                Contributors
                Journal
                0226703
                3266
                Demography
                Demography
                Demography
                0070-3370
                1533-7790
                2 June 2022
                01 June 2022
                01 June 2023
                : 59
                : 3
                : 1023-1043
                Affiliations
                School of Public Health and Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
                School of Public Health, University of Michigan, Ann Arbor, MI, USA
                School of Public Health, University of Michigan, Ann Arbor, MI, USA
                School of Public Health and Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
                School of Public Health, Brown University, Providence, RI, USA
                School of Public Health, Brown University, Providence, RI, USA
                Author notes
                Landon D. Hughes (corresponding author) landon@ 123456umich.edu
                Author information
                http://orcid.org/0000-0001-9558-3779
                http://orcid.org/0000-0002-4135-1603
                http://orcid.org/0000-0001-9405-7515
                http://orcid.org/0000-0001-9604-8380
                http://orcid.org/0000-0003-4722-8179
                Article
                NIHMS1808755
                10.1215/00703370-9942002
                9195044
                35548863
                5d0e3713-0ce5-4c23-87e7-833c9b9bb8ad

                This is an open access article distributed under the terms of a Creative Commons license (CC BY-NC-ND 4.0).

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                Categories
                Article

                Sociology
                mortality,transgender,disparity,life expectancy,gender
                Sociology
                mortality, transgender, disparity, life expectancy, gender

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