Health-related quality of life among transgender and gender expansive youth at a rural gender wellness clinic

O’Bryan, Jane; Scribani, Melissa; Leon, Kimberly; Tallman, Nancy; Wolf-Gould, Christopher; Wolf-Gould, Carolyn; Gadomski, Anne

doi:10.1007/s11136-020-02430-8

Cited by 22 publications

(16 citation statements)

References 32 publications

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“…Additionally, one study pointed to the fact that many TGD people rely on TGD networks to seek out affirming care [ 37 ]. In contrast to studies conducted with TGD people living in urban areas, rural TGD people may have even greater difficulty accessing these networks of other TGD people due to geographic isolation [ 38 ]. Generally, our findings are consistent with those found in urban areas insofar as difficulty accessing gender-affirming care, socioeconomic marginalization, and lack of provider education on TGD issues remain as barriers to accessing health care services [ 39 , 40 ].…”

Section: Discussionmentioning

confidence: 99%

Trans*Forming Access and Care in Rural Areas: A Community-Engaged Approach

Gandy-Guedes

Kidd

Weiss

et al. 2021

IJERPH

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Research indicates that rural transgender and gender diverse (TGD) populations have a greater need for health services when compared with their urban counterparts, face unique barriers to accessing services, and have health disparities that are less researched than urban TGD populations. Therefore, the primary aim of this mixed-methods study (n = 24) was to increase research on the health care needs of TGD people in a rural Appalachian American context. This study was guided by a community-engaged model utilizing a community advisory board of TGD people and supportive parents of TGD children. Quantitative results indicate that travel burden is high, affirming provider availability is low, and the impacts on the health and mental health of TGD people in this sample are notable. Qualitative results provide recommendations for providers and health care systems to better serve this population. Integrated mixed-methods results further illustrate ways that rural TGD people and families adapt to the services available to them, sometimes at significant economic and emotional costs. This study contributes to the small but growing body of literature on the unique needs of rural TGD populations, including both adults and minors with supportive parents, by offering insights into strategies to address known disparities.

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Section: Discussionmentioning

confidence: 99%

Trans*Forming Access and Care in Rural Areas: A Community-Engaged Approach

Gandy-Guedes

Kidd

Weiss

et al. 2021

IJERPH

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“…On average, trans people have significantly poorer mental health than the rest of the general population ( 39 , 50 ). This is particularly true for residents in rural areas.…”

Section: Resultsmentioning

confidence: 99%

Barriers to Accessing Health Care in Rural Regions by Transgender, Non-Binary, and Gender Diverse People: A Case-Based Scoping Review

et al. 2021

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Research shows an overrepresentation of trans people in vulnerable socioeconomic situations, primarily due to experiences of discrimination. At the same time, rural or suburban living areas often lack specialized trans-related health care, which a majority of trans people rely on to some extent. Taken together, the lack of both socioeconomic resources and access to trans-related health care can exacerbate health-related distress and impairment for trans people. We illustrate this problem using case vignettes of trans people from rural and suburban areas in (Northern) Germany. They are currently participating in an e-health intervention and randomized controlled trial (RCT) called i2TransHealth, whose case vignettes provided the impetus for the scoping review. The scoping review analyzes the impact of place of residence and its intersection with barriers to accessing trans-related health care. PubMed and Web of Science Data bases were searched for relevant studies using a search strategy related to trans people and remote, rural, or suburban residences. 33 studies were selected after full-text screening and supplemented via reference list checks and study team expertise by 12 articles addressing the living conditions of remotely living trans people and describing requirements for trans-related health care. The literature on trans people living remotely reveals intersections of trans mental health with age, race, gender expression, geographic location, community size, socioeconomic status, discrimination experiences, and attitudes towards health care providers. Several structural health care barriers are identified. The role of health care professionals (HCPs) for remotely living trans people is discussed. There is no need assuming that rural life for trans people is inevitably worse for health and well-being than urban life. Nevertheless, some clear barriers and health disparities exist for trans people in remote settings. Empowering trans groups and diversity-sensitive education of remote communities in private and institutional settings are needed for respectful inclusion of trans people. Facilitating access to trans-related health care, such as through video-based e-health programs with HCPs, can improve both the health and socioeconomic situation of trans people.

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“…Overall, rural LGBTQ+ adolescents were more likely to report depressive symptomology when compared with urban adolescents (Eisenberg et al, 2019; Price-Feeney et al, 2019) although one study reported no differences in depression scores (Li et al, 2018). Rural adolescents across the spectrum of sexual identities (e.g., lesbian, gay, bisexual, transgender, and gender expansive, and queer females) disclosed experiences of depression (Cusack & Numer, 2012; Eisenberg et al, 2019; Kosciw et al, 2015; Li et al, 2018; O’Bryan et al, 2020; Paceley, Fish, et al, 2020; Paceley, Goffnett, et al, 2017; Palmer et al, 2012; Price-Feeney et al, 2019; Roberts et al, 2018).…”

Section: Resultsmentioning

confidence: 99%

“…In comparison to U.S. standard populations and adolescents with two chronic conditions, rural transgender, and gender expansive (TG/GE) adolescents documented reduced HRQoL. TG/GE adolescents scored significantly lower on the psychosocial subscales of the CHQ-CF87 (role/social emotional functioning, self-esteem, and mental health) and the SF-36v2 (social functioning, emotional role, and mental health) (O’Bryan et al, 2020).…”

Section: Resultsmentioning

confidence: 99%

A Review of Psychosocial Protective and Risk Factors for the Mental Well-Being of Rural LGBTQ+ Adolescents

et al. 2021

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Lesbian, gay, bisexual, transgender, questioning/queer, and other gender diverse (LGBTQ+) adolescents face daunting hardships within the rural contexts they navigate (e.g., community, school), and these onerous demands make it difficult for them to maintain optimal mental well-being. This scoping review described the psychosocial protective and risk factors that shape mental well-being for rural LGBTQ+ adolescents and identified the mental health issues commonly reported by them. About 30 articles published between 2005 and 2020 were examined. A myriad of factors indicated protection of or risks to LGBTQ+ rural adolescents’ mental well-being through the social-ecological levels: individual (e.g., pressure to conform to gender norms, sexual exploration, coming out), interpersonal (e.g., connectedness, fear of rejection, religious beliefs), institutional/school (e.g., bullying victimization, social exclusion, peer/teacher intervention), and rural community (e.g., community size, local ties, social isolation). More research is needed to better understand and address rural mental health disparities for this vulnerable group.

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Health-related quality of life among transgender and gender expansive youth at a rural gender wellness clinic

Cited by 22 publications

References 32 publications

Trans*Forming Access and Care in Rural Areas: A Community-Engaged Approach

Trans*Forming Access and Care in Rural Areas: A Community-Engaged Approach

Barriers to Accessing Health Care in Rural Regions by Transgender, Non-Binary, and Gender Diverse People: A Case-Based Scoping Review

A Review of Psychosocial Protective and Risk Factors for the Mental Well-Being of Rural LGBTQ+ Adolescents

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