Experiences of Gender and Racial/Ethnic Discrimination in Sexual Healthcare Among Transgender and Nonbinary Young Adults of Color.

PURPOSE

Experiences of gender-based discrimination against transgender and nonbinary people and racial discrimination against people of color in sexual healthcare settings serve as significant barriers to care. However, the sexual healthcare experiences of transgender young adults of color (TNYAC), who face intersecting forms of discrimination, are poorly understood.

METHODS

We conducted a qualitative analysis of semi-structured interviews (n = 20) with TNYAC ages 20-30 years, residing across the United States. Interviews, conducted via Zoom from September 2021 to January 2022, focused on recent sexual healthcare experiences and potential discrimination based on gender or race. Researchers double-coded and, guided by intersectionality theory, analyzed transcripts using thematic analysis.

RESULTS

Among 20 interviewees with diverse racial/ethnic identities (Black, Latine, Asian-American and Pacific Islander, and multiracial), we identified several themes. Participants described how interpersonal and systemic interactions related to their gender and race determined their sexual healthcare experiences, specifically experiences of gender discrimination, racial stereotyping, and racial segregation. Importantly, participants noted ways their sexual healthcare experiences were shaped by intersecting systems of both racial and gender oppression. Lastly, participants developed identity-affirming protective strategies to navigate discrimination, such as independent information seeking or choosing providers with shared gender and/or racial identities.

DISCUSSION

The use of protective strategies in response to racial and gender discrimination in sexual healthcare highlights both the resilience of TNYAC and the need for equitable and inclusive healthcare services. Healthcare providers and practices can implement interventions like cultural humility training and co-located services to improve care for those who experience multiple forms of oppression.