Perceived Barriers and Facilitators to Health Care Utilization in the United States for Transgender People: A Review of Recent Literature

Lerner, Justin E.; Robles, Gabriel

doi:10.1353/hpu.2017.0014

Cited by 120 publications

(111 citation statements)

References 45 publications

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“…Basic requirements, including feeling safe and validated, are not being met. Consistent with previous research [5,[7][8][9][10][11], transgender participants in this study frequently indicated that current knowledge, experience, and professionalism amongst healthcare professionals around transgender health is poor and that there is a pressing need for better training for health professionals and more research in transgender healthcare. This includes training regarding using the correct name and pronouns, which has been shown to be vitally important in validating TGD experiences [10,[12][13][14].…”

Section: Discussionsupporting

confidence: 86%

Health Needs of Trans and Gender Diverse Adults in Australia: A Qualitative Analysis of a National Community Survey

Zwickl

Wong

Bretherton

et al. 2019

IJERPH

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There is an increasing demand for trans and gender diverse (TGD) health services worldwide. Given the unique and diverse healthcare needs of the TGD community, best practice TGD health services should be community-led. We aimed to understand the healthcare needs of a broad group of TGD Australians, how health professionals could better support TGD people, and gain an understanding of TGD-related research priorities. An anonymous online survey received 928 eligible responses from TGD Australian adults. This paper focuses on three questions out of that survey that allowed for free-text responses. The data were qualitatively coded, and overarching themes were identified for each question. Better training for healthcare professionals and more accessible transgender healthcare were the most commonly reported healthcare needs of participants. Findings highlight a pressing need for better training for healthcare professionals in transgender healthcare. In order to meet the demand for TGD health services, more gender services are needed, and in time, mainstreaming health services in primary care will likely improve accessibility. Evaluation of training strategies and further research into optimal models of TGD care are needed; however, until further data is available, views of the TGD community should guide research priorities and the TGD health service delivery.

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Section: Discussionsupporting

confidence: 86%

Health Needs of Trans and Gender Diverse Adults in Australia: A Qualitative Analysis of a National Community Survey

Zwickl

Wong

Bretherton

et al. 2019

IJERPH

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“…This research employs the unique approach of having youth comment on themes from healthcare providers, which yields strong recommendations that are directly relevant to the work force and their training needs. In this way, this study builds on previous research from both youth and adults (Corliss et al, 2007;Lerner & Robles, 2017;Roberts & Fantz, 2014;Safer et al, 2016;Snyder et al, 2016;Stoddard et al, 2011) regarding experiences of discrimination and other barriers to healthcare. Intervention and training activities based on these findings will address shortcomings in existing healthcare provider education and the expressed need for more robust training on…”

Section: Theme 2: Training For Healthcare Providersmentioning

confidence: 98%

“…Research has identified discrimination and a lack of knowledgeable healthcare providers as major barriers for TGD individuals seeking care (Corliss, Belzer, Forbes, & Wilson, 2007;Lerner & Robles, 2017;Roberts & Fantz, 2014;Safer et al, 2016;Snyder, Burack, & Petrova, 2016;Stoddard, Leibowitz, Ton, & Snowdon, 2011). Ignorance of gender issues may lead to unintentional but nonetheless stigmatising slights; examples of discriminatory mistreatment range from misuse of names and pronouns to outright denial of care for transgender patients (Grant et al, 2011).…”

mentioning

confidence: 99%

“It’s kind of hard to go to the doctor’s office if you’re hated there.” A call for gender‐affirming care from transgender and gender diverse adolescents in the United States

Eisenberg

McMorris

Rider

et al. 2020

Health Soc Care Community

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Research has identified discrimination and a lack of knowledgeable providers as major barriers for transgender and gender diverse (TGD) individuals seeking care, which contributes to greater stress and significant health disparities affecting this population. However, research involving TGD youth is limited. The aim of this study, therefore, was to describe TGD adolescents’ experiences, concerns and needs in healthcare settings, including their feedback on themes previously identified by healthcare providers (i.e. discomfort with gender‐related topics, reasons for not asking patients about gender and previous training regarding gender diversity). The authors conducted semi‐structured interviews with 12 TGD‐identified adolescents aged 14–17, living in Minnesota, USA in 2017–2018. Inductive thematic analysis was used to summarise participant comments into themes and subthemes. Two main themes were directly relevant to concerns and needs of TGD youth in healthcare settings and their views on healthcare providers’ concerns: (a) asking about gender and pronouns and (b) training for healthcare providers. Findings suggest the need for revisions to clinic materials, infrastructure and protocols. Adding training to all general medical and nursing education to increase knowledge, comfort and competence around gender identity would further improve care and ultimately reduce healthcare disparities affecting TGD youth.

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“…We examine the healthcare system and the labor market as two gendered institutions that influence BMSM’s preventive healthcare practices (Dovel et al, 2015; Fleming & Dworkin, 2016) and show how BMSM are negatively impacted by heteronormatively gendered institutional processes in health care and labor market settings. Assumptions about gender as a binary category mean that men often pay a penalty—in the form of social exclusion and stigma—for being gender non-conforming (Frye et al, 2015; Lerner & Robles, 2017; Messner, 1997; Sabo, 2005; Sevelius, Deutsch, & Grant, 2016). …”

Section: Introductionmentioning

confidence: 99%

Gendered Social Institutions and Preventive Healthcare Seeking for Black Men Who Have Sex with Men: The Promise of Biomedical HIV Prevention

Philbin

Parker

et al. 2018

Arch Sex Behav

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Research on gender and health, including research conducted among Black men who have sex with men (BMSM), has primarily focused on how gender norms and roles shape healthcare engagement. Here we advance that work by demonstrating how a broader theorization of gender, particularly one that moves beyond gender norms and performance to incorporate structures such as the healthcare system and the labor market, can facilitate an understanding of how gender affects preventive healthcare seeking among BMSM, particularly the uptake of pre-exposure prophylaxis (PrEP), a promising approach to alleviate HIV disparities. This article is based on a year-long ethnographic study conducted in New York City with BMSM (n = 31; three interviews each) and community stakeholders (n = 17). Two primary findings emerged: (1) the labor market systematically excluded the men in our sample, which limited their ability to access employer-sponsored healthcare. Such discrimination may promote overt demonstrations of masculinity that increase their HIV vulnerability and decrease healthcare seeking, and (2) healthcare systems are not structured to promote preventive healthcare for men, particularly BMSM. In fact, they constrained men's access to primary providers and were usually tailored to women. Applying a structural, gendered lens to men's health-in addition to the more frequently researched individual or interpersonal levels-provides insight into factors that affect healthcare seeking and HIV prevention for BMSM. These findings have implications for the design of policies and institutional reforms that could enhance the impact of PrEP among BMSM. Findings are also relevant to the management of chronic disease among men more broadly.

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Perceived Barriers and Facilitators to Health Care Utilization in the United States for Transgender People: A Review of Recent Literature

Cited by 120 publications

References 45 publications

Health Needs of Trans and Gender Diverse Adults in Australia: A Qualitative Analysis of a National Community Survey

Health Needs of Trans and Gender Diverse Adults in Australia: A Qualitative Analysis of a National Community Survey

“It’s kind of hard to go to the doctor’s office if you’re hated there.” A call for gender‐affirming care from transgender and gender diverse adolescents in the United States

Gendered Social Institutions and Preventive Healthcare Seeking for Black Men Who Have Sex with Men: The Promise of Biomedical HIV Prevention

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