Transgender and Non-Binary Patients Healthcare Experiences and Expectations: Results of a National Survey

Context: Gender minority individuals are a part of an underrepresented patient population that is experiencing obstructions and restrictions to gender affirming healthcare due to new legislation.

Objective: This study aimed to identify the satisfaction of transgender and non-binary patients with their healthcare experiences versus other members of the LGBT+ community.

Study Design/Setting/Dataset: This cross-sectional study utilized snowball sampling techniques and included recruitment through LGBT-friendly organizations, Twitter, emails, and ResearchMatch. The data was then analyzed using SPSS version 24 or higher and qualitative research methods.

Intervention/Instrument/Outcomes Measures: The 40-item survey included a mix of closed and open-ended questions regarding demographics, healthcare experiences, and health outcomes.

Population studied: Transgender and Non-Binary Individuals

Results: Overall, participants who identified as transgender had more positive experiences with their health care providers. While not statistically significant, 47% (46) of participants who identified as trans reported having an unmet health care need, compared to 56% (53) of non-trans participants. Trans participants were less likely to report that they had a negative reaction from a primary care provider (PCP) due to their gender identify when compared to non-trans participants (43% vs 55%, respectively). About 30% of all participants had a health care provider discourage exploring gender. Nonbinary participants, conversely, were less likely to report that their PCP was knowledgeable (p<.001) and informed (p=.015) about the care of transgender and gender nonconforming patients.

Conclusions: While many of the comments in the qualitative questions centered on high levels of dissatisfaction from transgender patients, we hypothesize that current relationships with PCPs are probably more positive due to the long-term relationships developed as a result of the need for quality, consistent care. Nonbinary patients were less likely to disclose their gender identity and were less satisfied with their overall experiences with their healthcare providers. Proving a more inclusive environment for gender minority patients can provide a better communication pathway for meeting expectations.