A Qualitative Evaluation of Transgender and Gender-Nonconforming Patients' Experiences in Southern California's Inland Empire

Angela Olivares; Justino Flores; Kodiak Ly; Chris Christensen; Brandon Brown; Andrea N Polonijo

doi:10.1089/trgh.2020.0187

A Qualitative Evaluation of Transgender and Gender-Nonconforming Patients' Experiences in Southern California's Inland Empire

Transgend Health. 2022 Oct 7;7(5):440-448. doi: 10.1089/trgh.2020.0187. eCollection 2022 Oct.

Authors

Angela Olivares¹, Justino Flores², Kodiak Ly³, Chris Christensen⁴, Brandon Brown⁵, Andrea N Polonijo⁶

Affiliations

¹ Department of Biochemistry, University of California, Riverside, Riverside, California, USA.
² Body Image, Sexuality, and Health Lab, California State University, San Diego, San Diego, California, USA.
³ Department of Sociology, University of California, Riverside, Riverside, California, USA.
⁴ HIV and Aging Research Project-Palm Springs, Palm Springs, California, USA.
⁵ Department of Social Medicine, Population, and Public Health, University of California, Riverside, Riverside, California, USA.
⁶ Department of Sociology, University of California, Merced, Merced, California, USA.

Abstract

Purpose: To evaluate negative and positive health care experiences within the racial-ethnically diverse transgender and gender-nonconforming (TGNC) community in the Inland Empire, California.

Methods: Three focus groups were conducted with a racial-ethnically diverse sample of 20 TGNC-identified individuals in California's Inland Empire. The rigorous and accelerated data reduction (RADaR) technique was used to systematically analyze the qualitative data and identify salient themes.

Results: Key themes included the following: a lack of TGNC cultural competency among providers, interpersonal barriers to health care, perceived systemic barriers to health care, and the effects of improper care on TGNC patients' health. Lack of cultural competency included providers' conflations of gender and sexuality and unawareness of nonbinary gender identities. Interpersonal barriers included patient experiences of being misgendered, refused treatment, and referred to by their deadnames. Perceived systemic barriers included insurance coverage, transportation issues, and a lack of expedient care. The effects of improper care were highlighted by participants seeking alternative and sometimes unsafe forms of care when timely and appropriate care was inaccessible.

Conclusion: Participants recommended increasing representation of TGNC perspectives into provider trainings, involving providers in outreach with the TGNC community, and requiring letters of recommendation and certifications for providers to be deemed TGNC culturally competent as means of improving TGNC patient care.

Keywords: Inland Empire; RADaR; focus group; health; transgender.