Transgender clients in rural areas and small towns.

Abstract

There is a crucial need for competent mental health services for persons who identify as transgender. This need is even greater for those who live in rural areas or small towns. However, there is little research on persons who are transgender who live in rural or remote areas. Typically, when rural populations are studied, gender minorities (e.g., transgender, gender nonconforming) are included with those who identify as sexual minorities (e.g., gay, lesbian, or bisexual). Studies that examine the needs of transgender persons generally do not parse out the experiences of those who live in rural areas versus those who live in urban areas. In this manuscript, we hope to begin to address this gap in the literature. We provide an overview of needs of rural-based transgender persons who are seeking health care services, we share case examples from clinical work with this population, and we provide recommendations for how mental health providers-both those who practice in rural areas and those who practice in urban areas-can work with transgender clients who live in rural and remote areas or small towns.

Recommendations from Transgender Healthcare Consumers in Rural Areas

“…Our 15-item semi-structured interview ( Table 2 ) was assembled based on our review of existing literature regarding healthcare access among transgender people 23 as well as LGBT access literature to supplement the sparse information that was available regarding only transgender populations. 26 The sequence and structure of questions built from general to more specific.…”

“… 7 , 22 Thus, guidelines for transgender treatment providers in rural areas include recommendations to include social support components. 23 …”

Overcoming the barriers in transgender healthcare in rural Ontario: discourses of personal agency, resilience, and empowerment

“…Part of the reason for this gap in the literature has been a prevailing – albeit often exaggerated – view that rural areas are a virtual “no man's land” for transgender people – that rural communities are ripe with transphobic violence and stigmatisms and, as a result, few (if any) transgender people reside in such regions (Abelson ). Consequently, many studies in transgender healthcare have simply ignored rural areas, while healthcare studies in rural areas have often categorised gender minorities – such as the transgender community – as being sexual minorities, indistinct from gay, lesbian, or bisexual communities (Koch and Knutson ). In an attempt to help fill this gap, the present study addresses questions pertaining to: (1) the barriers experienced by the transgender population to accessing healthcare in a more rural setting (Peterborough, Ontario, Canada – located 90 minutes away from the City of Toronto, with a population of 81,000 (Statistics Canada )); (2) how transgender individuals navigate the health system in an attempt to overcome these barriers; and (3) what policies and/or practices need to be implemented to improve interactions between HCPs and transgender patients.…”

Developing Trans-Affirming Health Services in an Underserved Area: An Intersectional Approach

“…Comprehensive healthcare and mental health services for transgender clients are a challenge in rural and urban areas. 36 Often, patients come to our clinic self-referred or referred by other patients as opposed to mental health providers, making mental health another issue that needs to be addressed in the establishment of healthcare for the transgender population. To address this concern, we collaborated with the psychiatry department at our institution to bring prompt attention to the evaluation of transgender patients.…”