Transgender people in the United States face multiple barriers to receiving gender-affirming healthcare. There is limited research on specific barriers, but what research does exist focuses on insurance and cost barriers, clinician-patient interactions, and broad social stigma. There is no known research focused on institution-level barriers to gender-affirming care.
In the reproductive health realm, researchers, advocates, and patients have identified hospital and other institution-level factors that are associated with access to comprehensive care. For gender-affirming care, there is also likely to be significant institution-level variation in access and evolving hospital policies.
Gender affirming care is best-practice medical care. Understanding the institutional barriers and facilitators gender expansive patients face when trying to access these services is crucial to understanding who has access to care, in what circumstances, and what patients perceive as contributors to the quality of their care.