This study aims to identify health disparities among transgender adults in South Korea (hereafter Korea), where they widely experience social stigma. We assessed prevalence of nine health indicators using a nationwide cross-sectional survey of 255 Korean transgender adults in 2017. Standardized prevalence ratios of these indicators were estimated using four nationally representative surveys in Korea that included the same health measures. Overall, transgender adults had a significantly higher risk of adverse health outcomes than the general population in Korea. Specifically, disparities in mental health outcomes between transgender adults and the general population were statistically significant. The prevalence of depressive symptoms was 6.44 and 9.71 times higher among transgender adults than women and men in the general population, respectively. For suicidal ideation, transgender adults reported 6.49 and 18.83 times greater risk than women and men in the general population, respectively. Our findings indicate that Korean transgender adults are at a higher risk of negative health outcomes than the general population.
American Psychological Association. Answers to Your Questions About Transgender People, Gender Identity, and Gender Expression. Washington, DC: American Psychological Association; 2011. https://www.apa.org/topics/lgbt/transgender.aspx. Accessed March 11, 2020.
3.
MeerwijkELSeveliusJM. Transgender population size in the United States: a meta-regression of population-based probability samples. Am J Public Health. 2017;107:e1-e8.
4.
ReisnerSLPoteatTKeatleyJ, et al. Global health burden and needs of transgender populations: a review. Lancet. 2016;388:412-436.
5.
TestaRJHabarthJPetaJBalsamKBocktingW. Development of the gender minority stress and resilience measure. Psychol Sex Orientation Gender Divers. 2015;2:65-77.
6.
BrownGRJonesKT. Mental health and medical health disparities in 5135 transgender veterans receiving healthcare in the Veterans Health Administration: a case-control study. LGBT Health. 2016;3:122-131.
7.
DowningJConronKHermanJLBlosnichJR. Transgender and cisgender US veterans have few health differences. Health Aff (Millwood). 2018;37:1160-1168.
8.
LefevorGTBoyd-RogersCCSpragueBMJanisRA. Health disparities between genderqueer, transgender, and cisgender individuals: an extension of minority stress theory. J Couns Psychol. 2019;66:385-395.
9.
ReisnerSLVettersRLeclercM, et al. Mental health of transgender youth in care at an adolescent urban community health center: a matched retrospective cohort study. J Adolesc Health. 2015;56:274-279.
10.
SuDIrwinJAFisherC, et al. Mental health disparities within the LGBT population: a comparison between transgender and nontransgender individuals. Transgend Health. 2016;1:12-20.
11.
CrissmanHPStroumsaDKobernikEKBergerMB. Gender and frequent mental distress: comparing transgender and non-transgender individuals’ self-rated mental health. J Womens Health (Larchmt). 2019;28:143-151.
12.
MeyerIHBrownTNHermanJLReisnerSLBocktingWO. Demographic characteristics and health status of transgender adults in select US regions: Behavioral Risk Factor Surveillance System, 2014. Am J Public Health. 2017;107:582-589.
13.
ReisnerSLWhiteJMBradfordJBMimiagaMJ. Transgender health disparities: comparing full cohort and nested matched-pair study designs in a community health center. LGBT Health. 2014;1:177-184.
14.
LaiMCChiuYNGadowKDGauSSFHwuHG. Correlates of gender dysphoria in Taiwanese university students. Arch Sex Behav. 2010;39:1415-1428.
15.
LeeHParkJChoiBYiHKimSS. Experiences of and barriers to transition-related healthcare among Korean transgender adults: focus on gender identity disorder diagnosis, hormone therapy, and sex reassignment surgery. Epidemiol Health. 2018;40:e2018005.
16.
YiHLeeHYoonJWParkJKimSS. Transgender people’s access to health care in Korea. Health Soc Welf Rev. 2015;35:64-94.
17.
KimSSParkJLeeHYiHChoiB. Unconditionally You—Experiences of Discrimination and Health of Korean Transgender People. Seoul, South Korea: Soombook; 2018.
18.
SonILeeHParkJKimSS. Social stigma and medical marginalization in healthcare service among transgender people in South Korea. Korean J Sociol. 2017;51:155-189.
19.
LeeHParkJKimSS. LGBTQI health research in South Korea: a systematic review. Health Soc Sci. 2014;36:43-76.
20.
LimHHJangYHChoiGYLeeJJLeeES. Gender affirmative care of transgender people: a single center’s experience in Korea. Obstet Gynecol Sci. 2019;62:46-55.
21.
Ministry of Health and Welfare; Korea Centers for Disease Control and Prevention. Korea health statistics 2017: Korea National Health and Nutrition Examination Survey (KNHANES VII-2). Seoul, South Korea: Ministry of Health and Welfare; 2018.
22.
TakeshitaJMasakiKAhmedI, et al. Are depressive symptoms a risk factor for mortality in elderly Japanese American men? The Honolulu-Asia Aging Study. Am J Psychiatry. 2002;159:1127-1132.
23.
YiHLeeHParkJChoiBKimSS. Health disparities between lesbian, gay, and bisexual adults and the general population in South Korea: Rainbow Connection Project I. Epidemiol Health. 2017;39:e2017046.
24.
Jung-ChoiKHKhangYHChoHJ. Hidden female smokers in Asia: a comparison of self-reported with cotinine-verified smoking prevalence rates in representative national data from an Asian population. Tob Control. 2012;21:536-542.
25.
ZahraACheongHKParkJH. Burden of disease attributable to smoking in Korea. Asia Pac J Public Health. 2017;29: 47-59.
26.
MeyerIH. Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: conceptual issues and research evidence. Psychol Bull. 2003;129:674-697.
27.
YangMFManningDvan den BergJJOperarioD. Stigmatization and mental health in a diverse sample of transgender women. LGBT Health. 2015;2:306-312.
28.
RegmiPRVan TeijlingenE. Importance of health and social care research into gender and sexual minority populations in Nepal. Asia Pac J Public Health. 2015;27:806-808.
29.
KimJKimHRyuM, et al. Human Rights Situation of LGBTI in South Korea 2017. Seoul, South Korea: SOGILAW; 2018.
