TransForming Access and Care in Rural Areas: A Community-Engaged Approach

• Published in: International journal of environmental research and public health Vol. 18; no. 23; p. 12700
• Main Authors: Gandy, Megan E, Kidd, Kacie M, Weiss, James, Leitch, Judith, Hersom, Xavier
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 02-12-2021; MDPI
• Subjects: Adult; Child; Community Participation; Decision making; Focus groups; Gender Identity; Health care; Health disparities; Health services; Humans; Mental health; Mixed methods research; Parents; Populations; Rural areas; Rural populations; Stakeholder Participation; Transgender Persons; Transsexualism; United States; Urban populations; United States; West Virginia; United States > US; access; nonbinary; mixed methods; transsexual; qualitative; health; discrimination; CBPR; health care; transgender
• ISSN: 1660-4601; 1661-7827; 1660-4601
• DOI: 10.3390/ijerph182312700

Research indicates that rural transgender and gender diverse (TGD) populations have a greater need for health services when compared with their urban counterparts, face unique barriers to accessing services, and have health disparities that are less researched than urban TGD populations. Therefore, the primary aim of this mixed-methods study (
= 24) was to increase research on the health care needs of TGD people in a rural Appalachian American context. This study was guided by a community-engaged model utilizing a community advisory board of TGD people and supportive parents of TGD children. Quantitative results indicate that travel burden is high, affirming provider availability is low, and the impacts on the health and mental health of TGD people in this sample are notable. Qualitative results provide recommendations for providers and health care systems to better serve this population. Integrated mixed-methods results further illustrate ways that rural TGD people and families adapt to the services available to them, sometimes at significant economic and emotional costs. This study contributes to the small but growing body of literature on the unique needs of rural TGD populations, including both adults and minors with supportive parents, by offering insights into strategies to address known disparities.