A Human Rights-based Approach to Measuring Geographic Access to and Availability of Transgender Healthcare

Authors: Avery Everhart*, University of Southern California
Topics: Medical and Health Geography, Human Rights, Gender
Keywords: transgender, access to healthcare, health and human rights, spatial availability of healthcare
Session Type: Virtual Paper
Presentation File: No File Uploaded


Geographic access to healthcare is often measured through floating catchment area (FCA) methods, or other methods for measuring travel time to care. However, general comment 14 on the right to health in the International Covenant on Economic, Social, and Cultural Rights outlines four principles for evaluating healthcare: availability, accessibility, acceptability, and quality (AAAQ). FCA methods only measure availability and not the four pillars of accessibility defined in human rights-based approaches to healthcare. Therefore, the paper outlines an intersectional method for quantifying the physical availability of healthcare as well as the financial, physical, informational, and non-discriminatory pillars of 'accessibility' from AAAQ using the California subsample of the United States Transgender Survey (2015) data and a geocoded database of trans-specific healthcare providers of the author's creation. Results from a typical FCA analysis demonstrate that mere location of healthcare facilities elides the complexity of accessing care for transgender communities who often face discrimination in accessing care. For example, trans people may be forced to travel much further than other communities to find a competent provider if the nearest one is financially or otherwise inaccessible. Bridging existing work on quantifying intersectional experiences and compounding stigma with spatial analysis and a rights-based approach to healthcare establishes what it necessary to proliferate genuine access to healthcare. Centering trans communities and their needs aids in discerning what it might take to solve disparities in access for everyone. Thus a rights-based and intersectional approach to measuring access to care is vital.

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