Housing Instability Characteristics Among Transgender Veterans Cared for in the Veterans Health Administration, 2013-2016

• Published in: American journal of public health (1971) Vol. 109; no. 10; pp. 1413 - 1418
• Main Authors: Carter, Sarah P, Montgomery, Ann E, Henderson, Emmett R, Ketterer, Bryan, Dichter, Melissa, Gordon, Adam J, Shipherd, Jillian C, Kauth, Michael R, Blosnich, John R
• Format: Journal Article
• Language: English
• Published: United States American Public Health Association 01-10-2019
• Subjects: Adult; Age Factors; Aged; AJPH Open-Themed Research; Cisgender; Classification; Comorbidity; Confidence intervals; Data analysis; Data warehouses; Epidemiology; Ethnicity; Female; Gays & lesbians; Gender; Gender aspects; Gender identity; Health care; Health care policy; Health services; Hispanic Americans; Homeless people; Homeless Persons - statistics & numerical data; Homelessness; Hospital administration; Housing; Housing - statistics & numerical data; Humans; Indigent care; Instability; Lesbian/Gay/Bisexual/Transgender Persons; Logistic Models; Male; Management; Marital status; Medical records; Medicine; Mental health; Middle Aged; Public health; Racial identity; Rural areas; Sex Factors; Sociodemographics; Socioeconomic Factors; Stability; Stability analysis; Statistical analysis; Transgender persons; Transgender Persons - statistics & numerical data; Transsexualism - epidemiology; United States; United States Department of Veterans Affairs - statistics & numerical data; Veterans; Veterans - statistics & numerical data; United States; United States > US
• ISSN: 0090-0036; 1541-0048
• DOI: 10.2105/AJPH.2019.305219

To characterize housing instability among transgender veterans using Veterans Health Administration (VHA) health care in the United States.
We used administrative data on veterans screened for housing instability from 2013 to 2016; participants included 5717 transgender veterans and 17 133 cisgender veterans. We defined housing instability by a positive screen or VHA Homeless Program use. We identified gender from medical records, reflecting either birth sex or gender identity. We identified transgender identity through transgender-related
and
codes. A multiple logistic regression assessed the association of transgender identity with housing instability.
Prevalence of housing instability was nearly 3 times higher among transgender veterans than among cisgender veterans (19.9% vs 6.7%;
 < .001). The difference persisted when we adjusted for sociodemographics (adjusted odds ratio = 2.32; 95% confidence interval = 2.09, 2.57). Transgender veterans experiencing housing instability were more likely than cisgender veterans to be women, younger, unmarried, and White.
Transgender veterans experience housing instability more frequently than do cisgender veterans. An increased focus on transgender identity is critical for reducing veteran homelessness.