Trans-masculine experiences navigating health care in the Dominican Republic: Barriers, resilience and community

Background Trans-masculine individuals in Latin America and the Caribbean face unique healthcare barriers shaped by stigma, religion, cultural norms, and structural inequities. Despite growing research on transgender women’s health in this region, little is known about the healthcare experiences of trans-masculine populations, particularly in the Dominican Republic (DR).Methods We conducted 11 semi-structured individual interviews and 2 focus groups (n = 13) with trans-masculine individuals in the DR to explore healthcare experiences and access, including barriers and facilitators to care. Narrative and thematic analysis identified patterns in experiences navigating multiple types of health care.Results Participants (median age 29, IQR = 11) described limited availability and affordability of gender-affirming care, discrimination and misgendering in healthcare settings, fear of medical services, and non-affirming mental health care influenced by providers’ religious beliefs. Healthcare facilitators included peer- and community networks, a community-created WhatsApp; and a peer-developed directory listing affirming providers, affordable pharmacies, and services to avoid. Participants recommended expanding public insurance coverage, increasing trained providers, and establishing specialized gender-affirming care centers.Conclusions Findings highlight the urgent need for culturally competent, gender-affirming care for trans-masculine individuals in the DR. Integrating community knowledge into formal healthcare systems and improving provider training are critical for advancing equity for this population.