Lesbian, Gay, Bisexual, Transgender, and Queer + (LGBTQ+) populations, especially transgender and gender nonconforming (TGNC) individuals, face considerable mental health disparities, social stigma, discrimination, and minority stress. Thomas et al. (2025) found that TGNC people frequently experience Healthcare Avoidance and Delay (HAD) as a result of systemic and interpersonal barriers, which in turn lead to worse health outcomes. Factors influencing HAD include the inability to pay, a lack of trust, the expectation that providers will not understand their needs, and previous negative encounters (Thomas et al., 2025). Another study identified a shortage of LGBTQ+-specialized, in-network providers and fear of gatekeeping gender affirming care as further reasons TGNC individuals avoid care (Schuller et al., 2025).
When TGNC individuals enter healthcare spaces, they can encounter insensitivity and anti-LGBTQ bias, according to Schuller et al. (2025). Navigating the system can involve filling out non-affirming intake forms or dealing with discriminatory policies. In my own experience, even when the environment should be affirming, the general attitude towards TGNC individuals is unclear. At a large hospital’s gender health clinic, I frequently second-guess which restroom to use because of its shared space with the OB/GYN offices. Negative experiences with providers, whether a personal experience or one reported by others in the community, impact a patient’s choice to engage in mental health services (Schuller et al., 2025).
References
Schuller, K. A., Crawford, R. P., & Wolf, M. (2025). Predictors of mental health service utilization among transgender and gender nonconforming adults. Transgender Health, 10(1), 73–83. https://doi.org/10.1089/trgh.2023.0107
Thomas, S. D., Dempsey, M., King, R. J., & Murphy, M. (2025). Health care avoidance and delay in the transgender population: A systematic review exploring associations with minority stress. Transgender Health, 10(2), 126–149. https://doi.org/10.1089/trgh.2022.0202