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Katarina Ferrucci has received a TL1 Pre-Doctoral Fellowship Training Grant

Katarina Ferrucci, PhD Candidate has received a TL1 Pre-Doctoral Fellowship Training Grant. Her research Focuses on transgender older adults and examines pain management, preventative care engagement, and the quality of care for older transgender persons. This multi-aim mixed-methods research project strives to inform healthcare systems and policymakers of pain management, preventative care engagement, and the quality of care older transgender persons receive.

Transgender people often face numerous barriers to both routine and gender affirming care. These are, in part, attributable to discriminatory and non-inclusive care experiences with providers and health systems. Transgender people often experience multiple negative health outcomes and have lower health related quality of life. Access to gender affirming care has expanded in recent years, allowing older transgender persons access to these resources for the first time in their lives. Older transgender individuals living in nursing homes are susceptible to similar experiences with satisfaction and discrimination from staff and healthcare providers.

Chronic pain is common among adults over 65 years of age. Transgender persons are more likely to experience chronic disease and pain management may suffer.

This project employs the MarketScan claims database and the Centers for Medicare and Medicaid Services’ Minimum Data Set (MDS) 3.0 (a comprehensive quarterly assessment of all nursing home residents in the United States) linked to Medicare parts A and D claims. Qualitative patient and provider narratives concerning transgender patient and resident experience with quality of care and care seeking behaviors will also be collected.

We hypothesize that older transgender adults will be more likely to receive higher quality pain management and routine preventive care services after accessing gender-affirming transition care and that Transgender residents will be more likely to have undertreated pain and poorer care quality than comparable residents within the same nursing homes.