Table 4 Factors associated with the unwillingness to receive counseling from gender-affirming healthcare providers
Variables | Unwillingness | Univariable analysis | Multivariable analysis | ||
|---|---|---|---|---|---|
Characteristics | n (%) | cOR (95% CI) | P | aOR (95% CI) | P |
Age | Â | Â | 0.703 | Â | Â |
  < 25 years (ref.) | 4/24 (16.7) | 1 |  |  |  |
  ≥ 25 years | 10/74 (13.5) | 0.78 (0.22 – 2.78) |  |  |  |
Region of residence | Â | Â | 0.854 | Â | Â |
 Bangkok | 4/31 (12.9) | 0.89 (0.25 – 3.11) |  |  |  |
 Others (ref.) | 10/70 (14.3) | 1 |  |  |  |
Religion | Â | Â | 0.864 | Â | Â |
 Buddhist (ref.) | 14/95 (14.7) | 1 |  |  |  |
 Others | 1/8 (12.5) | 0.83 (0.09 – 7.32) |  |  |  |
Highest education level | Â | Â | 0.529 | Â | Â |
  < A bachelor's degree | 10/61 (16.4) | 1.45 (0.46 – 4.63) |  |  |  |
  ≥ A bachelor's degree (ref.) | 5/42 (11.9) | 1 |  |  |  |
Employment status | Â | Â | 0.552 | Â | Â |
 Self-employed/business owner (ref.) | 1/16 (6.3) | 1 |  |  |  |
 Full-time | 9/51 (17.6) | 3.21 (0.37 – 27.84) |  |  |  |
 Part-time/student/unemployed | 5/36 (13.9) | 2.42 (0.26 – 22.83) |  |  |  |
Relationship status | Â | Â | 0.618 | Â | Â |
 Partner (ref.) | 7/42 (16.7) | 1 |  |  |  |
 Single | 8/61 (13.1) | 0.75 (0.25 – 2.28) |  |  |  |
Experience of unfair gender discrimination from healthcare providers | Â | Â | 0.005 | Â | Â |
 Yes (ref.) | 2/54 (3.7) | 1 |  |  |  |
 No | 13/49 (26.5) | 9.39 (1.98 – 44.49) |  |  |  |
Monthly income (baht) | Â | Â | 0.859 | Â | Â |
  < 15,001 | 7/47 (14.9) | 1.58 (0.29 – 8.41) |  |  |  |
 15,001 – 30,000 | 5/34 (14.7) | 1.55 (0.27 – 8.94) |  |  |  |
  > 30,000 (ref.) | 2/20 (10.0) | 1 |  |  |  |
Sex work experience | Â | Â | 0.593 | Â | Â |
 No (ref.) | 14/92 (15.2) | 1 |  |  |  |
 Yes | 1/11 (9.1) | 0.56 (0.07 – 4.75) |  |  |  |
Gender identity | Â | Â | 0.277 | Â | 0.862 |
 Transgender men (ref.) | 5/23 (21.7) | 1 |  | 1 |  |
 Transgender women | 10/80 (12.5) | 0.51 (0.16 – 1.70) |  | 0.90 (0.26—3.09) |  |
Gender-affirming healthcare service | |||||
 Perception of whether gender-affirming healthcare services for transgender individuals exist in Thailand |  |  | 0.096 |  | 0.033 |
  Known (ref.) | 7/68 (10.3) | 1 |  | 1 |  |
  Unknown | 8/35 (22.9) | 2.58 (0.85 – 7.88) |  | 3.70 (1.11—12.36) |  |
Attitudes toward healthcare | |||||
 Buy hormones or medicine without doctor supervision |  |  | 0.019 |  | 0.010 |
  Agree (ref.) | 4/58 (6.9) | 1 |  | 1 |  |
  Disagree/neutral | 11/45 (24.4) | 4.37 (1.28 – 14.92) |  | 5.53 (1.50—20.42) |  |
 Transgender health concerns are different from cisgender ones |  |  | 0.055 |  |  |
  Agree (ref.) | 5/58 (8.6) | 1 |  |  |  |
  Disagree/neutral | 10/44 (22.7) | 3.12 (0.98 – 9.97) |  |  |  |
 Seeking healthcare providers who understand transgender concerns is easy |  |  | 0.455 |  |  |
  Agree (ref.) | 5/26 (19.2) | 1.57 (0.48 – 5.15) |  |  |  |
  Disagree/neutral | 10/76 (13.2) | 1 |  |  |  |
 A high chance of gender discrimination by healthcare providers |  |  | 0.056 |  |  |
  Agree (ref.) | 4/52 (7.7) | 1 |  |  |  |
  Disagree/neutral | 11/51 (21.6) | 3.30 (0.97 – 11.23) |  |  |  |
 Avoid visits to healthcare providers |  |  | 0.679 |  |  |
  Agree (ref.) | 3/25 (12.0) | 1 |  |  |  |
  Disagree/neutral | 12/78 (15.4) | 1.33 (0.34 – 5.20) |  |  |  |