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Older adulthood is a crucial time in the health management journeys of transgender and non-binary (TNB) people. Understanding how the COVID-19 pandemic has impacted TNB older patients (65 years and over) offers critical guidance for successful health services reform and continued delivery systems change. Using qualitative data from 47 semi-structured individual interviews, I investigate how TNB older Americans—as a medically and socially vulnerable population in the United States—manage their health during the COVID-19 pandemic. Results indicated a need for enhancing health services and resources for TNB older adults while creating a culture of age-friendly and gender-affirming healthcare. Four primary themes emerged: (1) exacerbated mental health challenges, (2) disrupted social relationships and support, (3) adopting cost-effective health management strategies, and (4) incorporating family care partners in health management. Such themes were shaped by respondents' privileged and marginalized social locations, such as access to financial security, social support, and adequate medical care. Although these research findings should not be generalized to the TNB older adult population, they suggest that broader patterns of inequity affect how TNB older Americans manage their health during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

In this case, cisgender medical providers - both supportive of and resistant to the inclusion of trans competency in healthcare provision - engage in a process of "doing cisgender" whereby they manage their own and others' emotions regarding trans healthcare in ways that uphold cisnormativity within healthcare systems and, in turn, the continued marginalization of transgender patients (Sumerau & Mathers, 2019). Study Design The purpose of this study was to understand medical providers' knowledge about and experience with providing healthcare to transgender patients. Establishing guidance within healthcare systems that all providers must have the capacity to effectively provide gender-affirming care can begin to reset the culture of medicine, which currently allows for elective provider knowledge and for providers to opt out of caring for members of particular populations based on their personal preferences. [Extracted from the article]

Objective Data Sources and Study Setting Study Design Data Collection/Extraction Methods Principal Findings Conclusions To determine the barriers transgender and gender nonconforming (TGNC) adults face when accessing or receiving healthcare in the United States.Primary data were collected between September 2022 and March 2023 from a purposive sample of TGNC adults (N = 116 participants) using an online survey with a series of open‐ended and closed‐ended questions.Thematic analysis was employed to extract and analyze participants' responses to an open‐ended question about challenges they experienced when accessing or receiving healthcare. Two members of the research team conducted qualitative data analyses using Dedoose. The quality of each analysis was subsequently reviewed by a third research team member.Data were collected from responses to one open‐ended question that asked about participants' healthcare barriers as a TGNC individual.Five main themes surrounding healthcare barriers emerged from the content analysis: (1) acceptability, (2) accommodation, (3) affordability, (4) availability, and (5) accessibility. First, participants who noted acceptability issues reported explicit discriminatory treatment from providers, providers not using their chosen names and pronouns (e.g., misgendering), and provider refusal to provide gender‐affirming care. Second, participants who experienced accommodation challenges identified provider medical training gaps on TGNC patient needs and administrative barriers to care. Third, participants explained affordability issues due to a lack of adequate health insurance coverage. Fourth, participants described availability challenges with accessing hormone therapy prescriptions. Finally, participants noted accessibility issues with obtaining TGNC‐specific care at LGBTQ+‐affirming clinics.There is a growing interest in the needs of TGNC adults within healthcare settings. This requires that health policies are enacted to ensure that TGNC adults have access to healthcare that is accommodating and accepting/affirming. Study findings may provide insight into the potential impact of current legislation on transgender access and availability. [ABSTRACT FROM AUTHOR]