Coming home to my body”

A qualitative exploration of gender-affirming care-seeking and mental health

Bibliographic Data

ID15682247
AuthorsTeddy G Goetz (0000-0002-1138-6602, University of Pennsylvania, corresponding author), Amanda C Arcomano (University of Pennsylvania)
Year2023
Volume27
Issue4
Pages380-400
Publication date2023-09-05
Open AccessNo
TypeARTICLE
VenueJournal of Gay & Lesbian Mental Health (JOURNAL)
Journal identifiersISSN: 1935-9705 • E-ISSN: 1935-9713
PublisherTaylor & Francis (PUBLISHER • GB)
DOI10.1080/19359705.2023.2237841
PMID38078052
OpenAlexW4386439937
LanguageEN
Citations received4
References cited18

Among transgender, non-binary, and/or gender expansive (TNG) persons, interest in medical and/or surgical forms of gender affirmation is heterogenous, as is access to those forms of medically necessary health care. Yet, the literature characterizing TNG persons' interest in medical and/or surgical gender-affirming care, barriers to accessing that care, and how societal narratives and expectations impact TNG individuals' self-image and mental health, as well as their personal choices regarding gender-affirming care remains sparse. Here we present qualitative research exploring TNG participants' interest in gender-affirming care and how such interventions impact identity formation. We conducted loosely structured interviews with a convenience sample of 54 TNG persons in the U.S. and Canada from Facebook pages used to recruit TNG research participants. One-hour interviews were conducted by an openly TNG researcher; participants were compensated. The most frequently sought gender-affirming care was hormone therapy, followed by chest ("top") surgery, genital ("bottom") surgery, electrolysis, breast augmentation, hysterectomy, and voice training. Less commonly desired interventions included fertility preservation, facial feminization/masculinization, and vocal surgery. Participants described four main categories of access barriers: financial (e.g., cost of medical/surgical care, inadequate insurance), logistical (e.g., no local providers, gatekeeping policies around body size and mental health, pandemic-related delays), personal fears about sub-optimal outcomes (e.g., complications, loss of sensation, undesired aesthetic and/or functional results), and societal discrimination (e.g., familial rejection, job loss, safety concerns). Participants reported primarily seeking this healthcare for social legibility, alleviating dysphoria/pursuing euphoria, and/or gender exploration. All who sought gender-affirming care reported improved mental health-including depression, anxiety, dissociation, and eating disorders-and social relationships, though many struggled to find TNG-competent mental health providers. This work provides key insights into how gender-affirming care can contribute to improving mental health for TNG communities, which will assist health providers in optimally treating TNG patients

Gatekeeping · Gender dysphoria · Health care · Mental health · Psychiatry · Psychological intervention · Qualitative research · Thematic analysis · Transgender · Transsexual · Feminist Theory and Gender Studies · Gender, Feminism, and Media · LGBTQ Health, Identity, and Policy · Medicine · Nursing · Psychology

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