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Primary Submission Category: LGBTQ+
Access to mental healthcare among transgender, non-binary, and gender-expansive adults by racially minoritized status and rurality
Authors: Tai Simpson, Kaylee Wilson, Gabe Miller, Stephanie Hernandez,
Presenting Author: Tai Simpson*
Background: Mental health disparities among transgender, non-binary, and gender-expansive (TNBGE) adults are underexplored, particularly at the intersection of racially minoritized status and rurality. Examining access to mental healthcare related to gender identity (GI) and/or transitioning is crucial to understanding disparities.
Objective: To assess desire for and access to GI/transition-related mental healthcare among TNBGE adults by racially minoritized status and rurality.
Method: We used data from the 2022 United States Transgender Survey (n = 78,659). Using an intersectional framework, we created a composite variable combining racially minoritized status and rurality to examine how overlapping forms of marginalization shape health outcomes. Modified Poisson regression with robust error variance estimated associations between racially minoritized status-rurality and desiring and receiving counseling for GI and transitioning.
Results: The sample included 1.4% racially minoritized rural residents, 7.7% non-racially minoritized rural residents, 20.6% racially minoritized non-rural residents, and 70.3% non-racially minoritized non-rural residents. Desire for counseling did not differ significantly across groups. After adjusting for sociodemographic and socioeconomic factors, compared to non–racially minoritized non-rural residents all other groups were less likely to have received counseling (racially minoritized rural PR = 0.87, 95% CI: 0.81–0.92; non-racially minoritized rural PR = 0.88, 95% CI: 0.86–0.91; racially minoritized non-rural PR = 0.94, 95% CI: 0.93–0.96).
Conclusion: Despite similar desire for care, racially minoritized rural TNBGE adults had less access to GI/transition-related mental healthcare. These findings underscore the necessity of policies and interventions aimed at increasing access to care for TNBGE adults. Future research should examine specific barriers driving these inequities in GI/transition-related mental healthcare access.