Transgender care is health care: barriers and proposed model to improve access for transgender adults.

Over 1 million transgender individuals, including transfeminine, transmasculine, non-binary, and gender-diverse individuals (trans) live in the United States.1 The 2015 US Transgender Survey (N = 27,715) found that of the respondents who had seen a health care provider within the past year, 33% reported harassment or denial of care when seeking health care because of their trans identity.2 Furthermore, 23% of respondents reported avoiding essential care due to fear of mistreatment, and 33% did not get necessary care because they could not afford it. Trans patients experience health disparities because of multifactorial barriers to care, including lack of insurance, financial instability, language, transportation, and discrimination. However, the most reported barrier to comparable medical care for trans patients is the lack of knowledgeable providers (32% of respondents), followed by access to a trans-friendly provider (30%), cost (29%), access to a specialist (28%), location (18%), and language (13%).3 We posit that provider knowledge gaps are due to 2 primary reasons: attribution bias and trans erasure at the informational and institutional levels.