Abstract
To most demographers and policy scholars, discussions about gender equity in health may entail consideration of various health outcomes in relation to just two population groups, males and females, or men and women. The result is that public policy debates and decisions both passively and actively promote cisnormativity, or the notion that one’s assigned sex at birth should match their gender identity. This chapter examines healthcare utilization among transgender and gender-nonconforming people and the nature of transition-related healthcare policies across 28 European countries using the first large-scale survey of lesbian, gay, bisexual, and transgender people conducted in 2012. My results suggest that countries with higher levels of healthcare utilization among trans individuals also reported greater health parity between “women and men,” and that countries with less inequality between “women and men” provided more expansive support for transitions. But broadly speaking, masculinizing surgeries are covered more evenly across the European Union member countries, compared to feminizing surgeries, meaning female and male body ideals impact policy decisions differently. To ensure more equitable democratic process for all, it is crucial that we pay attention to trans rights and experiences for our understanding of public policy making.
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Notes
- 1.
Values inside the parentheses correspond to 95% confidence intervals calculated from the weighted sample.
- 2.
Whittle et al. (2008) and Castagnoli (2010) noted that application procedures in Romania were unclear and lacked legal certainty, while van den Brink and Dunne (2018) and the ILGA-Europe (n.d.) include Romania as one of the countries that recognize preferred gender through judicial procedures since 2008. Classification of Hungary also differed across experts, wherein Whittle et al. (2008) cautioned that procedures in Hungary were unclear, but Castagnoli (2010) and van den Brink and Dunne (2018) saw possibilities of legal gender recognition. I have classified both countries as lacking consistent legal frameworks to not overstate the efficacy of these procedures.
- 3.
An examination of insurance coverage in the United States indicates that roughly the same share of insurance policies covers phalloplasty and vaginoplasty in states that prohibit transgender exclusions, while the coverage rates are slightly higher for vaginoplasty than phalloplasty in states that do not prohibit transgender exclusions (96.2 vs. 93.6%) (Almazan et al., 2020).
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Strader, E. (2022). Demographics of Transgender People and Transition-Related Healthcare Policies Across the European Union. In: Baumle, A.K., Nordmarken, S. (eds) Demography of Transgender, Nonbinary and Gender Minority Populations. Springer, Cham. https://doi.org/10.1007/978-3-031-06329-9_8
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