Trauma type influences women’s health care-related trust and engagement.

Despite having greater health service needs, trauma survivors often report reduced health care engagement. This association can be, at least in part, explained by survivors' mistrust of providers. To date, the differential impact of specific trauma types on health care-related trust and engagement remains unknown. This study examines the unique influence of various trauma types on trust in doctors and health care underutilization in a community sample of women. Participants (N = 150 women, 66.7% White; Mage = 41.5 years, SDage = 11.8 years) recruited via an online crowdsourcing platform completed survey measures assessing traumatic experiences, trust in doctors, health care underutilization, and posttraumatic stress disorder symptoms. In regression models controlling for all other trauma types and posttraumatic stress disorder symptoms, experiencing other unwanted sexual experiences, B = -7.34, p < .001, predicted trust in doctors, F(19, 127) = 2.94, p < .001, R² = .31, and experiencing other unwanted sexual experiences, B = 1.01, p = .002; assault with a weapon, B = 1.31, p = .011; and exposure to toxic substances, B = 1.60, p = .014, predicted health care underutilization, F(19, 127) = 4.14, p < .001, R² = .38. There was a significant indirect effect from other unwanted sexual experiences to health care underutilization via trust in doctors when accounting for other trauma types and posttraumatic stress disorder symptoms, F(20, 126) = 5.76, p < .001, R² = .48. Findings remained significant when race was included in models post hoc. Specific trauma types-experiencing other unwanted sexual experiences, assault with a weapon, or exposure to toxic substances-were more predictive of trust in doctors and/or underutilization than others, pointing to the importance of providers incorporating patients' trauma histories into their understanding of the patient-provider relationship and women's health care behaviors. (PsycInfo Database Record (c) 2025 APA, all rights reserved).