“The doctors have more questions for us”: Geographic differences in healthcare access and health literacy among transgender and nonbinary communities

Abstract

Transgender and nonbinary (TNB) individuals experience a variety of systemic barriers that impact their ability to access healthcare, often leading to negative health outcomes. Previous research has suggested that improving health literacy among marginalized communities may help reduce existing health disparities. Yet few studies have examined health literacy among TNB people and how health literacy and healthcare access may differ by urbanicity. Using the capabilities theoretical approach, the current study uses data from six focus groups ( N=40) from metropolitan, urban, and rural areas in Colorado to examine geographic differences in health literacy and healthcare access. Findings show that geographic differences in accessing healthcare include transportation issues, having to travel far distances to access care, finding a TNB-affirming and competent provider, and needing to educate providers and staff. These differences were more prevalent among TNB people living in non-metropolitan areas. Additionally, our findings suggest that TNB individuals have high levels of health literacy due to having to self-educate and exist within a healthcare system that was designed for cisgender people.

Health literacy of trans and gender diverse individuals –a cross sectional survey in Germany

“…Overall, the results undermine the results of Pho, Bakken [ 11 ], stating the health literacy of trans and gender diverse individuals is limited. This should be considered problematic, as previous research suggests, that trans and gender diverse individuals even need a higher degree of health literacy to navigate the health care system [ 16 ]. Consequently, the low degree of health literacy might be another reason, why trans and gender diverse individuals might not seek health care next to avoidance due to fear.…”

“…Low health literacy is associated with worse health outcomes in different samples [ 15 ]. Yet, little is known about the health literacy of trans and gender diverse individuals, even though trans and gender diverse individuals might need a higher degree of health literacy in order to navigate in a medical system that is based on a binary, biological gender system [ 16 ]. First qualitative studies therefore describe, that trans and gender individuals might have a good health literacy, as the participants themselves reported a good seeking behavior as well appraisal of information [ 17 , 18 ].…”