Transgender and Gender Diverse Youths' Perspectives on Barriers and Facilitators to Affirming Care

Abstract 

Background. Transgender and gender diverse (TGD) youth experience minority stressors including stigma and discrimination that can negatively impact health and well-being. Timely access to quality care is key to addressing these concerns. Receiving supportive and quality care during adolescence and emerging adulthood is a pivotal step in addressing TGD health inequality. This study aimed to identify barriers and facilitators to mental health and TGD affirming medical care for TGD youth. Understanding barriers and facilitators to care represents a crucial step to mitigating health disparities for TGD youth by providing context-rich insights that can enhance care accessibility and quality. Methods. TGD youth ages 12 to 24 (N = 31) shared their perspectives in a 45-minute qualitative semi-structured interview. Qualitative Descriptive methodology using a conventional content analysis technique was employed to analyze the data. Results. Youth identified five themes of barriers to care including: 1) Cultural and Sociopolitical; 2) Stigma & Discrimination; 3) Family-Related; 4) Health-Related; and 5) Structural & Systemic barriers. Four themes of facilitators for care were identified including: 1) Community-based; 2) Facility Accommodations & Funding; 3) Family; and 4) School & Education-Based facilitators. Conclusions. TGD youth face a myriad of barriers to receiving mental health and TGD affirming medical care. Despite these obstacles, TGD youth have insightful perspectives on how to facilitate access to care. This study sheds light on the urgent need for inclusive, youth-informed practices that prioritize equity and access to affirming care for TGD youth.