Social support experiences of trans women/transfeminine adults accessing gender-affirming hormone therapy

Gender affirming health care (GAHC), particularly gender-affirming hormone therapy, can promote the well-being of transgender women/transfeminine persons. Social gender affirmation, in the form of social support (e.g., use of one's authentic name and pronouns), may complement and strengthen trans people's experiences with GAHC. Most research to-date has focused on social support during GAHC with children and adolescents rather than adults, who experience unique social support needs when navigating health care. Given this gap and an increasingly hostile sociopolitical context limiting transgender and gender diverse people's access to both GAHC and social support, we explored the social support experiences of trans women/transfeminine persons taking gender-affirming hormone therapy. We utilized a convergent parallel mixed methods study design drawing on secondary cross-sectional survey data from 214 trans women/transfeminine persons in Canada aged 18+ taking gender-affirming hormone therapy for ≥3 months. Bivariable analyses explored factors associated with having social support while accessing GAHC. Qualitative data from open-ended survey responses were analyzed using directed qualitative content analysis. Among participants (mean age: 32.3, standard deviation: 10.8), most (94.4%) reported having at least one person who supported them. Those receiving social assistance and those of Black race/ethnicity were statistically significantly less likely to report having social support. Narratives revealed positive and negative interpersonal interactions from partners, family (parents, siblings, chosen), and friends (particularly queer-/trans-identified), influenced by emotional capacity, anti-trans stigma, and pretransition relationship dynamics. Social support improved individuals' mental health, increased participants' community connectedness, and enhanced trans joy. These findings underscore the importance of providers fostering social support among trans women/transfeminine people accessing GAHC. (PsycInfo Database Record (c) 2026 APA, all rights reserved).