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Epidemiology and Health 2018;e2018005.
DOI: https://doi.org/10.4178/epih.e2018005    [Accepted] Published online February 27, 2018.
Barriers to Transition-related Healthcare among Korean Transgender Adults: Focused on Gender Identity Disorder Diagnosis, Hormone Therapy, and Sex Reassignment Surgery
Hyemin Lee1  , Jooyoung Park1  , Bokyoung Choi1  , Horim Yi1  , Seung-Sup Kim1,2 
1Department of Public Health Sciences, Graduate School of Korea University, Seoul, Korea
2Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA, USA , Boston, United States
Correspondence  Seung-Sup Kim ,Tel: +82-10-3152-8334 , Email: ssk3@korea.ac.kr
Submitted: November 29, 2017  Accepted after revision: February 27, 2018
Previous literature has documented that transgender people may encounter barriers when they use transition-related healthcare services. This study aims to investigate the experiences of transition-related healthcare and the barriers to those services among transgender adults in South Korea.
In 2017, we conducted a nationwide cross-sectional survey of 278 transgender adults in South Korea. We assessed the prevalence of transition-related healthcare such as Gender Identity Disorder (GID) diagnosis, hormone therapy, and sex reassignment surgery. To understand the barriers to those procedures, we asked the participants for their reason not to receive each of the three procedures. We also examined their experiences of and reasons for using non-prescribed hormone medication.
We found that 91.0% have been diagnosed with GID (N=253/278), 88.0% have received hormone therapy (N=243/276), and 42.4% had any type of sex reassignment surgery (N=115/271). Cost was the most common barrier to transition-related healthcare among the Korean transgender adults. Other common barriers were identified: Negative experiences in healthcare settings, lack of healthcare professionals and facilities, and social stigma against transgender people. Among those who have taken hormone therapy, 25.1% (N=61/243) reported that they had experience of purchasing hormone medication without medical prescription.
Our findings suggest that transgender people face barriers to transition-related healthcare in South Korea. These barriers may preclude transgender individuals from safely accessing to transition-related healthcare. Improving access to transition-related healthcare requires institutional interventions including expanding national health insurance coverage on those procedures and providing transition-related training programs for healthcare professionals in South Korea.
Keywords: Transgender Persons; Health Services for Transgender Persons; Sex Reassignment Surgery; Sexual and Gender Minorities; Gender Identity; Republic of Korea
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