INTRODUCTION: Abortion and gender-affirming care promote bodily autonomy, are subject to societal stigmatization, and are targets of political interference. Providers of this care face unique challenges due to these factors. The objective of this study is to explore the challenges that abortion and gender-affirming providers face and to understand the factors that are supportive of their work. METHODS: This qualitative study involved semistructured focus groups and individual interviews with 15 physicians who provide abortion care, gender-affirming care, or both in the United States from December 2024 to February 2025. Recruitment was conducted using convenience and snowball sampling. Focus groups and interviews were conducted online, recorded, and transcribed. Data were analyzed using deductive and inductive coding and thematic analysis. This study was approved by the University at Buffalo IRB (ID: STUDY00008840). RESULTS: Fifteen providers participated (seven abortion providers, four gender-affirming care providers, and four who provide both). Participants identified as cis, trans, and nonbinary and represented every major region of the United States. Most participants were actively pursuing or had recently completed subspeciality training. Isolation and stigmatization emerged as major challenges. Of the supportive factors that emerged, professional networks, interprofessional collaboration, and relationships with providers of nonclinical services were identified as particularly valuable. CONCLUSIONS/IMPLICATIONS: Strategies that promote professional networks and foster multidisciplinary collaboration may help overcome some of the unique challenges that providers of abortion and gender-affirming care face, given the highly stigmatized and politicized nature of this health care.
Sawester et al. (Thu,) studied this question.