Gender-affirming care, including hormone therapy, "top" (e.g., chest reconstruction surgery) and "bottom" (e.g., vaginoplasty, phalloplasty, metoidioplasty, etc.) surgeries, and puberty blockers, is an efficacious treatment of gender dysphoria for transgender and gender nonconforming (TGNC) individuals. However, many TGNC people encounter significant barriers in accessing gender-affirming care, which we detail via results from on online study. Participants included 256 TGNC individuals (78.9% White, ages 16-73, =28.4). Among participants, 61.3% were receiving hormone therapy, 22.7% had undergone top surgery, and 5.5% had undergone bottom surgery. Open-ended responses (=201) were thematically analyzed and common barriers included finances and insurance issues, a lack of service availability, and fears or worries. Participants reported various systemic issues and incidents of bias within medical and mental health fields, as well as a lack of medical provider awareness and education. Other themes were interpersonal barriers (e.g., fears of rejection); age and need of parental consent for minors; other medical issues; and a lack of information about how to acquire care. These findings can be utilized to educate professionals in medical and mental health fields about barriers their TGNC patients may encounter in receiving affirming care, and suggest a number of ways to improve access to these services.

Shifting cultural attitudes and legislation have increased focus on the healthcare needs of lesbian, gay, bisexual, transgender, and queer (LGBTQ) patients. However, patient non-disclosure of LGBTQ identity creates a barrier to accessing care. This study examined a diverse sample of LGBTQ young adults and their experiences of disclosure and non-disclosure to medical providers. Participants (N = 206, age range 18–27) completed questionnaires assessing healthcare access and use as part of a larger study. Participants’ responses to open-ended items asking about experiences of LGBTQ identity disclosure to medical providers and reasons for non-disclosure were analyzed thematically. Results revealed intra- and interpersonal factors related to patient disclosure. Reasons for participant non-disclosure included providers not asking about identity, internalized stigma, and belief that health and LGBTQ identity are not related. When participants did disclose, they experienced reactions ranging from discrimination and disbelief to affirmation and respect. Findings confirm and extend previous research on young adults’ identity disclosure and provide avenues continuing education for health professionals working with LGBTQ patients.

No abstract

Transgender (trans) individuals and their partners demonstrate significant diversity in terms of sexuality and approaches to romantic relationships. Over 3/4 (77%) of trans individuals identify as sexual minorities, but little is known about how they negotiate sexual and gender identities within a relationship. Additionally, findings have indicated that trans individuals and their partners utilize nonmonogamous relationship structures, but research focused on how these relationships develop and the function of consensual nonmonogamy (CNM) is limited. The goal of this study was to address these gaps through an exploration of CNM in a sample of trans individuals and their partners who participated in a larger study about sex, sexuality, and sexual practice. The subsample consisted of 12 individuals (6 couples) who discussed CNM as part of their broader discussion of relationships and sexual practice. Four individuals (2 couples) were currently engaged in relationships with extradyadic partners. In terms of sexual identity, 67% of participants (n ϭ 8) identified as bisexual-queer-pansexual. A majority of participants identified as transgender (67%; n ϭ 8), and participants' ages ranged from 23 to 39 (M ϭ 30.2, SD ϭ 5.5). Transcripts were analyzed using Charmaz's (2014) approach to grounded theory. Themes identified during analysis highlight factors that facilitate and hinder the development of CNM relationships and individual and relationship factors that impact CNM relationships among trans individuals and their partners. Public Significance StatementThis study advances the idea that consensual nonmonogamy may be an important component of some transgender individuals' and their partners' lives. Results suggest that specific factors related to transgender identity, such as openness to new experiences or adjustment related to defying social norms, may create a unique process that allows for additional possibilities for relationships.

No abstract