Social stigma and health care utilization among gender diverse adults

The present study examines the relationships between different forms of stigma related to one's weight and gender identity on health care utilization within a gender diverse sample.

Gender diverse individuals across the weight spectrum were recruited from an online panel via Prolific. Participants completed questionnaires regarding health care experiences, health behaviors, health beliefs, and gender identity. Data were collected between September and November 2023.

The final sample was 343 transgender and nonbinary participants. Adding weight stigma (enacted, internalized), transgender stigma, and intersectional stigma to the models accounted for 49.8% of the variance in weight-based health care avoidance, ΔR² = .217, ΔF(4, 331) = 35.80, p < .001, and 13.1% of the variance in general avoidance of health care, ΔR² = .071, ΔF(4, 331) = 6.72, p < .001. Adding the stigma variables to the model predicting health care delay accounted for 13% of the variance, ΔR² = .08, ΔF(4, 331) = 7.60, p < .001. However, adding stigma did not uniquely contribute to the variance in hormonal gender affirming care interest, ΔR² = .014, ΔF(4, 331) = 1.68, p = .155, gender affirming care typical for those assigned male at birth, ΔR² = .050, ΔF(4, 76) = 1.18, p = .325, and gender affirming care typical for those assigned female at birth, ΔR² = .029, ΔF(4, 197) = 1.80, p = .131.

Results partially supported our hypotheses, suggesting both enacted weight/transgender stigma and internalized weight stigma are significantly associated with utilization of health care services in a gender diverse sample. Future research is needed to understand the relationships between coping strategies and health care utilization. (PsycInfo Database Record (c) 2026 APA, all rights reserved).