Gender-Affirming Primary Care Access Among Rural Transgender and Gender Diverse Adults in Five Northeastern U.S. States

Purpose: Little is known about the prevalence and predictors of gender-affirming primary care (GAPC) access among rural transgender and gender diverse (TGD) adults. This study therefore sought to characterize the prevalence and predictors of GAPC within a sample of rural TGD adults. Methods: A nonprobability convenience sample ( n = 244) of rural TGD adults was recruited across five Northeastern U.S. states (Connecticut, Massachusetts, New Hampshire, New York, Vermont) and completed a health needs assessment from March 2019 to October of 2019. Results: Transgender women and men had higher odds of accessing GAPC than nonbinary and gender diverse respondents. Respondents aged 25–39 had higher odds of accessing GAPC than those 18–24 years old. Conclusion: This study found high prevalence of barriers to GAPC among rural TGD people, highlighting system-level improvement opportunities.