Public Preferences Regarding Equitable Healthcare Rationing Across Gender Identities in China

Public opinion on public healthcare rationing regarding gender identity is crucial for democratic policymaking because of public concern regarding sexual orientation, gender identity, and gender expression (SOGIE). Based on rationality theory, rationally equitable rationing depends on equity orientations and prioritizing public interest over self-interest. Specifically, equity orientations include those toward equality, need, personal contribution, and social contribution. To project public preference for public healthcare rationing, this study involved 744 Chinese people in a web survey. These participants indicated their preferences for public healthcare rationing and self-interest, public interest, and equity orientations, including those based on contribution, equality, and need. Regression analysis based on the rationality framework showed that public healthcare rationing that was equal across SOGIE identities was predominantly preferable, based on rational equity. In contrast, public healthcare rationing without considering SOGIE was less preferable, and rationing unequally across gender identities was not preferred. These results imply that affirmative and egalitarian rationing is the most rationally equitable approach.