Dental Fear Among Transgender Individuals

Objectives: The aims of this study were to evaluate levels of dental fear among transgender individuals and to investigate associations between gender identity (GI) and dental fear.
Methods: A survey asked about dental fear (Dental Fear Survey (DFS)), fear of being discriminated against/maltreated in the dental clinic (5-point Likert scale, “Not at all (1)” to “Extremely fearful (5)”) and gender characteristics. We asked their gender identity by two steps; whether participants considered themselves to be transgender/gender non-conforming (yes/no) and how they describe their gender identity (e.g., transgender male). Questions were adapted from the National Transgender Discrimination Survey.
Results: Sixty-nine transgender individuals participated in this study (mean (s.d.) age=37.0(16.1), range 18-76 years). The number of transgender male (TM), transgender female (TF) and non-conforming (NC) individuals were 25, 30 and 14, respectively. The mean (s.d.) of DFS scores for TM, TF and NC were 44.7 (17.8), 47.9 (20.7), and 58.1 (19.4), respectively. Analyses of variance found no significant differences in DFS scores among GIs (F=2.24, p=0.115). There was a significant correlation between fear of discrimination in the dental clinic and dental fear (Pearson's r = 0.45, p<0.001). A regression model with DFS as the independent variable and GI, age and fear of discrimination as dependent variables was significant (F=4.22 (4,58), p=0.005, R^2=0.25). Standardized coefficient of the fear of discrimination was 0.42 (p=0.001), while the other dependent variables were not significant.
Conclusions: The fear of discrimination in the dental office was significantly associated with dental fear in this sample of transgender individuals, even though dental fear did not differ by gender identity. Dental providers should be aware of patients’ fear of discrimination among the transgender community. Investigations are needed to examine the role of gender in the dental fear level, which has been constantly reported at greater levels in females than in males.