Intersectional vulnerabilities to extreme weather among transgender, nonbinary, and genderqueer respondents in Ohio, USA

Introduction Transgender, nonbinary, and genderqueer individuals face heightened disaster vulnerability due to systemic marginalization, including discriminatory policies, poverty, and limited health care access. Despite increasing climate impacts, transgender communities around the world remain largely invisible in disaster planning and response. People with disabilities also face disproportionate vulnerability during disasters, encountering barriers to evacuation, shelter access, and recovery efforts. Grounded in the minority stress framework and informed by intersectional approaches to climate justice, this study examines how gender identity and disability status intersect to shape disaster vulnerability.Methods Drawing on survey data from transgender, nonbinary, and genderqueer respondents (n = 198) within a larger study of LGBTQIA+ participants, conducted in Fall 2024 in Ohio, United States, we examined the intersection of disability and gender identity during flooding and extreme heat events. Using Firth’s bias-reduced logistic regression models, we quantified the odds of experiencing mental and physical health impacts and anticipated barriers to disaster services.Results Disabled transgender individuals were associated with elevated likelihood of adverse outcomes compared to nondisabled, nonbinary respondents, including 5.7 times greater odds of flood-related mental health stress (p < 0.001), 3.0 times higher odds of heat-related mental health stress (p = 0.02), 3.2 times higher odds of heat stress (p = 0.02), and 6.0 times greater odds of heat stroke (p < 0.001). Disabled transgender respondents also had 14.2 times greater odds of anticipating limited access to disaster recovery services due to fear of discrimination or violence (p < 0.001). Findings support prioritizing the continuity of gender-affirming care during climate disasters with practice considerations for emergency health care providers.Conclusion Intersecting marginalized identities are associated with increased vulnerabilities during disasters, with implications for regions where restrictive gender policies intersect with climate threats. These findings contribute foundational quantitative evidence to support more equitable climate adaptation and emergency preparedness policies.