Influences of health care access on resilience building among transgender and gender non-binary individuals

Abstract

Background: Health care disparities between transgender/gender non-binary individuals and the general population are well-documented and related to both interpersonal and institutional discrimination. Resilience has been found to buffer the negative health effects of discrimination among gender diverse individuals as well as other stigmatized populations.

Aims: The purpose of this study was to identify and understand resilience related to health and health care among a community sample of transgender and gender non-binary individuals in the southern United States.

Methods: We conducted 35 longitudinal photo elicitation interviews with 21 participants among a community sample of transgender and gender non-binary individuals in the Southern US. Interview transcripts were coded using thematic analysis and themes were organized according to the Resilience Activation Framework.

Results: Overall, individual and community-level resources within the domains of social and human capital were frequently activated to navigate challenges related to seeking and receiving health care. Lack of access to resources in economic and political capital domains constrained resilience.

Discussion: This work demonstrates how stakeholders can identify target areas for interventions and policy change aimed at improving resilience in transgender and gender non-binary communities by utilizing the Resilience Activation Framework. In our sample, we found that resources should be directed toward building economic and political capital at the community level so participants have the ability and opportunity to marshal such resources.

Keywords:

• Health care
• LGBT
• resilience
• transgender
• non-binary

Notes

Acknowledgments

We would like to thank the participants for sharing their experiences and photographs. This work could not have been done without the help of Victoria Schoebel, Sarah Piperato, and Transcend Charlotte.

Notes

1 Gender non-binary refers to those whose gender does not correspond to “man” or “woman,” including gender queer, gender fluid, agender, among others.

2 Cisnormative refers to assumptions that a person’s gender corresponds to the sex they were assigned at birth and heteronormative refers to assumptions that an individual is heterosexual in their identity and/or behaviors.

3 Femme here is used to describe gender queer individuals who present and/or act in feminine way.