Recognizing and Addressing Health Care Barriers for Transgender and Nonbinary People Living With a Chronic Illness or...

Area of Science:

• Health Services Research
• Sociology of Health and Illness
• Gender Studies

Background:

• Transgender and/or nonbinary (TGNB) individuals often face unique health care challenges.
• The intersection of TGNB identity with chronic illness and/or disability (CI/D) can compound these barriers.
• Understanding these compounded experiences is crucial for improving health equity.

Purpose of the Study:

• To explore the health care experiences of TGNB individuals living with CI/D.
• To identify barriers encountered within the health care system.
• To propose actionable solutions for enhancing care quality and affirming patient identities.

Main Methods:

• Interpretivist epistemological worldview and an intersectional lens.
• In-depth interviews with TGNB individuals with self-identified CI/D.
• Thematic analysis of qualitative data by an interdisciplinary research team.

Main Results:

• Participants reported diagnostic overshadowing and provider skepticism exacerbated by dual TGNB-CI/D identities.
• Frequent health care interactions led to negative encounters, including misdiagnosis and gender-related questioning.
• Gaslighting, lack of LGBTQ+ competent care, and discrimination resulted in delayed or forgone essential health services.

Conclusions:

• Advocating for LGBTQ+ competent care through provider education is essential.
• Structural changes addressing financial and insurance barriers are needed.
• Leveraging telehealth and strengthening community support networks can mitigate disparities and improve care.