Transgender healthcare with challenges, disparities, and the path forward: a retrospective study at a tertiary care hospital in Paris, France

Abstract

Background: Transgender individuals face stigma, violence, and healthcare disparities worldwide. Despite increasing research, data on access to care remain limited. This study aims to describe the demographic, social, and health characteristics of transgender patients attending of transgender individuals seeking care at a single center in Paris, France. Methods: We conducted a retrospective, single-center, descriptive study of transgender individuals who sought care at the infectious diseases department of a tertiary care hospital in Paris, France, between June 2021 and June 2022. Results: A total of 50 transgender individuals were included, predominantly transgender women (49/50). Most participants were born in Brazil (39/50) and engaged in sex work (41/50). A large proportion faced precarious social conditions, with 35/50 being undocumented migrants and 23/50 lacking healthcare insurance. Despite 44/50 reporting good overall health, 37/50 expressed a need for primary healthcare, yet only 19/50 had consulted a general practitioner in France, primarily through word of mouth (8/19). Language barriers were a major obstacle to care (16/50). Comorbidities were common, including substance use (27/50), HIV (32/50), and at least one sexually transmitted infection in the past year (24/50). Participants also reported high rates of violence (33/50), anxiety (32/50), and depression (28/50). Conclusion: Transgender individuals seeking care at our center experience significant social and medical vulnerability, with many healthcare needs remaining unmet. Strengthening social and administrative integration, along with leveraging community organizations and healthcare mediators, is essential to improving access to care and support for this population.