Healthcare experiences of transgender and non-binary people in the Canary Islands, Spain: a qualitative phenomenological study

Background Transgender and non-binary people experience barriers when accessing healthcare, despite increasing recognition of gender diversity. Understanding how these experiences are shaped by organizational, interpersonal, and identity-related factors is essential to improve equitable and affirming healthcare.Aims To explore healthcare experiences of transgender and non-binary people in the Canary Islands and to identify the interpretative axes.Methods A hermeneutic-phenomenological approach was conducted in the Canary Islands, Spain (December 2025-March 2026). Fourteen participants were recruited through purposive convenience and snowball sampling. Eligible participants were aged ≥18 years, accessed at least one healthcare service within the previous five years, and able to communicate in Spanish. Data were collected through semi-structured interviews and analyzed inductively using thematic analysis supported by ATLAS.ti. Co-occurrence analysis was performed to identify relationships between subthemes and higher-order interpretative axes.Results Inductive thematic analysis identified 28 subthemes organized into seven overarching themes describing healthcare experiences characterized by organizational barriers, fragmented access to gender-affirming services, limited professional competence in gender diversity, identity invalidation, and significant emotional consequences. Co-occurrence identified three interpretative axes linking structural barriers, recognition of gender identity, and emotional responses, highlighting the interconnected nature of healthcare experiences.Conclusions Healthcare experiences of transgender and non-binary people are shaped by the interaction between healthcare organization, professional competence, and identity affirmation. Improving access to coordinated, affirming, and person-centered healthcare, together with strengthening education in gender diversity, should be prioritized to reduce health inequities. Interpretative axes identified provide an integrated framework that may inform future research and development of more inclusive healthcare models.