%A Taylor Boyer
%T Comparison of healthcare experiences and healthcare avoidance between binary and nonbinary transgender youth
%X Background: There is growing research exploring the underlying causes of health disparities experienced by transgender communities. Little research has explored the unique healthcare experiences of transgender youth, particularly nonbinary youth, which may help explain the mechanisms contributing to health outcomes for gender minority youth. 
Aims: To compare the positive and negative healthcare experiences and healthcare avoidance between binary and nonbinary transgender youth. 
Methods: A cross sectional survey was conducted with transgender youth between the ages of 12 and 26 years old receiving gender-affirming care at the Gender Clinic at UPMC Children?s Hospital of Pittsburgh. Participants were recruited during clinical hours with eligible and consenting youth who had a clinic visit during the study period (July ? October 2018). 181 youth were surveyed including 141 binary youth (103 binary transmasculine and 38 binary transfeminine youth) and 40 nonbinary youth (24 nonbinary assigned female at birth (AFAB), 8 nonbinary assigned male at birth (AMAB), and 8 nonbinary youth who did not indicate their sex assigned at birth).  
Results: There are no statistically significant differences in healthcare experiences and healthcare avoidance for nonbinary youth compared to binary youth. Nonbinary youth, particularly nonbinary AFAB (Coefficient: 0.99; p = 0.05) and nonbinary AMAB (Coefficient: 1.45; p = 0.06), reported more negative healthcare experiences than binary transfeminine youth when controlling for age and race/ethnicity. However, compared to binary transmasculine youth, neither nonbinary AFAB (Coefficient: 0.34; p = 0.44) nor nonbinary AMAB (Coefficient: 0.80; p = 0.27) had significantly more negative healthcare experiences. Regardless of gender identity, more negative healthcare experiences were statistically associated with healthcare avoidance (OR: 2.02; 1.58, 2.59). Parental support and positive healthcare experiences did not moderate the association between negative healthcare experiences and healthcare avoidance.    
Conclusions/Public Health Statement: These findings indicate that healthcare experiences may be different for nonbinary youth compared to binary transfeminine youth. However, more research with larger sample sizes of nonbinary youth is needed to support and fully explore these differences. It is imperative that future research explores the potentially unique healthcare experiences of nonbinary transgender youth to reduce health disparities and promote positive health outcomes for this population.
%D 2019
%K transgender 
youth
healthcare 
healthcare avoidance 
healthcare experiences
%I University of Pittsburgh
%L pittir35564