Purpose: There are many barriers to reliable healthcare for transgender people that often contribute to delaying or avoiding needed medical care. Yet, few studies have examined whether noninclusive healthcare and delaying needed medical care because of fear of discrimination are associated with poorer health among transgender adults. This study aims to address these gaps in the knowledge base.Methods: This study analyzed secondary data from a statewide survey of 417 transgender adults in the Rocky Mountain region of the United States. Independent variables included noninclusive healthcare from a primary care provider (PCP) and delay of needed medical care because of fear of discrimination. Dependent variables assessed general health and mental health.Results: Transgender individuals who delayed healthcare because of fear of discrimination had worse general health in the past month than those who did not delay or delayed care for other reasons (B=−0.26, p<0.05); they also had 3.08 greater odds of having current depression, 3.81 greater odds of a past year suicide attempt, and 2.93 greater odds of past year suicidal ideation (p<0.001). After controlling for delayed care because of fear of discrimination, having a noninclusive PCP was not significantly associated with either general health or mental health.Conclusion: This study suggests a significant association between delaying healthcare because of fear of discrimination and worse general and mental health among transgender adults. These relationships remain significant even when controlling for provider noninclusivity, suggesting that fear of discrimination and consequent delay of care are at the forefront of health challenges for transgender adults. The lack of statistical significance for noninclusive healthcare may be related to the measurement approach used; future research is needed to develop an improved tool for measuring transgender noninclusive healthcare.

Transgender and gender non-conforming people frequently experience discrimination, harassment, and marginalization across college and university campuses (Bilodeau, 2007; Finger, 2010; Rankin et al., 2010; Seelman et al., 2012). The minority stress model (Meyer, 2007) posits that experiences of discrimination often negatively impact the psychological wellbeing of minority groups. However, few scholars have examined whether college institutional climate factors-such as being denied access to bathrooms or gender-appropriate campus housing-are significantly associated with detrimental psychological outcomes for transgender people. Using the National Transgender Discrimination Survey, this study analyzes whether being denied access to these spaces is associated with lifetime suicide attempts, after controlling for interpersonal victimization by students or teachers. Findings from sequential logistic regression (N = 2,316) indicate that denial of access to either space had a significant relationship to suicidality, even after controlling for interpersonal victimization. This article discusses implications for higher education professionals and researchers.

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Within higher education settings, transgender people are at risk for discrimination and harassment within housing and bathrooms. Yet, few have examined this topic using quantitative data or compared the experiences of subgroups of transgender individuals to predict denial of access to these spaces. The current study utilizes the National Transgender Discrimination Survey to research this issue. Findings indicate that being transgender and having another marginalized identity matters for students' access to housing and bathrooms. Trans women are at greater risk than gender non-conforming people for being denied access to school housing and bathrooms. Implications for practice and research are detailed.

Research indicates that transgender individuals frequently experience marginalization and interpersonal victimization within college and university settings. Missing from the literature is a discussion of what can be done to address such patterns in higher education, based upon empirical data gathered from transgender and gender non-conforming students, staff, and faculty. The present study aims to fill this gap by reporting on solutions offered by a sample of 30 individuals in one U.S. state while integrating a lens of intersectionality.Five resulting themes include: (a) offer education, campus programming, and support for trans individuals; (b) improve university systems and procedures for recording one's name and gender; (c) encourage greater inclusivity and recruitment of diverse groups; (d) make physical changes to facilities; and (e) hold people accountable. These findings suggest institutional actions and policy changes for higher education administrators and others committed to improving campuses for transgender and gender non-conforming people.Keywords: transgender, higher education, qualitative methods, recommendations, intersectionality K.L. Seelman Gender & Education 4As noted by Beemyn (2005b), a growing number of transgender individuals are choosing to be 'out' while enrolled in a college or university in the United States. Yet, few college campuses are comprehensively prepared to meet the needs of transgender students, let alone staff or faculty members. Research indicates that transgender and gender non-conforming individuals tend to experience multiple forms of marginalization and interpersonal victimization on campus, including: (1) being denied access to or questioned within campus housing and bathrooms Missing from the literature is a discussion of what can be done to address such patterns in higher education, based upon empirical data gathered from transgender and gender nonconforming students, staff, and faculty. The present study aims to fill this gap by reporting onsolutions offered directly by this population based on their lived experiences. This paper begins with a review of the literature related to transgender people's experiences in higher education and relevant theoretical frameworks, starting with definitions of a few key terms.In this paper, the term transgender is defined as: a range of gender experiences, subjectivities and presentations that fall across, between or beyond stable categories of 'man' and 'woman'… [The term transgender includes] gender identities that have, more traditionally, been described as 'transsexual,' and a diversity of genders that call into question an assumed relationship between gender identity and presentation and the 'sexed' body. This theory base articulates how structures beyond interpersonal interactions comprehensively impact trans and gender non-conforming people.Although the theory base informing institutional cisgenderism has a primary focus on gender, this is not to say that all transgender and gender non-conforming people experience...