Predictors of Mental Health Service Utilization Among Transgender and Gender Nonconforming Adults

The purposes of this study were to determine which transgender and gender nonconforming (TGNC) adults used mental health services in the past 12 months, to compare TGNC who did and did not access mental health care, to query reasons for not accessing mental health services, and to determine what indicators influenced mental health service utilization.

The research team gathered data from 274 TGNC adults from September to November 2019 via an electronic survey. This exploratory study assessed mixed methods data on mental health services utilization. The convergent, parallel mixed methods design was used to compare and interpret the quantitative and qualitative data for convergence or divergence.

Approximately 24% of TGNC adults did not use mental health services, with 44% of that group indicating it was because they did not need them, which means that 56% needed services but did not use them. The top reasons for not accessing needed mental health services included: inability to pay, not believing that care would be effective, not expecting to find providers who understood specific TGNC experiences or needs, and not trusting mental health professionals. Income, location, and mental health status were significant indicators.

This study provides evidence that some TGNC adults who do not utilize mental health services still need them while outlining the specific barriers that inhibit TGNC adults from accessing needed mental health care. Comparing TGNC adults who did and did not access mental health services reveals that mental health status, location, and income are predictive of mental health service utilization. Recommendations are discussed.