Published Date: January 20, 2024

Summary: Transgender women (TW) experience significant inequities in health care access and health disparities compared to cisgender populations. Access to nontransition-related health care is understudied among TW. Authors aimed to assess the association between access to care and gender minority stress and resilience factors among TW living with and without HIV in eastern and southern United States.

This study was a cross-sectional analysis of baseline data drawn from a cohort of 1,613 adult TW from the Leading Innovation for TW’s Health and Empowerment (LITE) Study. Data from the 2011 California Health Interview Survey (CHIS) was used in this study.

Findings: Higher levels of gender minority stress, as measured by anticipated discrimination and nonaffirmation were associated with decreased access to health care. Among TW living with HIV, higher levels of anticipated discrimination, nonaffirmation, and social support were associated with decreased health care access.

Gender minority stress was associated with increased barriers to health care access among TW in the U.S., regardless of HIV status. Resilience factors did not mediate this effect. Interventions aiming to increase health care access among TW can be aided by efforts to mitigate drivers of gender minority stress and improve patient experiences in health care facilities.

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