“Trans broken arm”: Health care stories from transgender people in rural areas

Douglas Knutson, Julie M. Koch, Tori Arthur, T. Andrew Mitchell, Meredith A. Martyr


According to scholars, transgender and gender diverse individuals suffer disproportionately from health related concerns such as depression, anxiety, psychological distress, and HIV infection. Scholars have also found that transgender people experience high rates of homelessness, harassment, violence, and unemployment. These challenges may ultimately affect the physical and emotional health of transgender individuals. Recently, calls for health related research among LGBT individuals have intensified and scholars and practitioners have begun to focus more heavily on provision of health care to transgender and gender diverse individuals. These efforts have been directed in part by general guidelines produced by national professional organizations. However, little is known about the health related experiences of transgender people in rural and remote areas of the United States, where individuals may face unique issues and barriers. Thus, the present study was designed to provide rich qualitative data illustrating encounters between rural transgender people and health professionals as well as how the rural or remote location of participants plays a role into their health care experiences and access. We used semi-structured interviews to assess the health care related experiences of 10 transgender and gender diverse individuals in rural and remote areas of the U.S. Our analysis resulted in 4 main categories with 12 domains. We present these results and include quotes and vignettes to further illustrate the experiences of our participants. We also present recommendations from participants for providers including suggestions about outreach and training for providers.  In the discussion, we highlight ways study relates to guidelines offered elsewhere. 


transgender; rural; health; qualitative

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