A multisector study assessing readiness for providing gender-affirming services to transgender women

Transgender women experience significant health disparities and are at disproportionately high risk of violence, stigmatization, and discrimination. Stigma and discrimination are enacted by staff and leaders in multiple public and service sectors including housing, physical and behavioral health, criminal justice and law enforcement, workforce development, and education. Multisectoral approaches recognize that health involves coordination and cooperation across various sectors, government departments, and stakeholders. The purpose of this study was to assess readiness and capacity to provide gender-affirming services.

The Division Director of Access to Prevention, Advocacy, Intervention and Treatment/Special Services for Groups a nonprofit organization recruited participants via email from the following 10 sectors: behavioral health, medical, disability, law enforcement, criminal justice, housing, workforce development, faith-based, legal aid, and education. In-depth interviews were conducted with 44 participants. Interviews were transcribed and analyzed using a framework approach, a method of deductive analysis. Participants (n = 27) attended a follow-up meeting that included a presentation of the findings from the interview analysis and held small group discussions about sector capacity for gender-affirming services.

Findings indicated that the capacity of providing training, leadership support, and policies varied. Gaps included a lack of funding for trainings and programs, the need for a more exclusive focus on transgender issues, and inclusion of transgender women participation to ensure the inclusion of their lived experiences.

Results suggest that a multisectoral approach is feasible. Across participants, best practices included clear and explicit trans-affirming policies, establishment of safe spaces/physical indicators of allyship, and representation within organizations of members of the lesbian, gay, bisexual, transgender, queer, intersex, asexual, and other sexual identities community (including employment and visible supportive images). (PsycInfo Database Record (c) 2025 APA, all rights reserved).