ORIGINAL RESEARCH article
Front. Health Serv.
Sec. Patient Centered Health Systems
This article is part of the Research TopicAdvancing Inclusive Sexual Health: Education and Empowerment for LGBTQIA+ and Minority CommunitiesView all articles
Cross-sectional analysis of delays in care and interactions with healthcare providers among transgender and gender diverse individuals
Provisionally accepted
- 1Department of Neurology, Mayo Clinic Minnesota, Rochester, United States
- 2Department of medicine, University of Miami Miller School of Medicine, Miami, United States
- 3Cancer Control and Population Sciences Division, Universidad de Puerto Rico Centro Comprensivo de Cancer, San Juan, Puerto Rico
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Introduction: Timely access to positive, culturally competent healthcare experiences may be critical for transgender and gender diverse (TGD) individuals. However, gaps remain in our understanding of TGD individuals’ access to these experiences. Our aim was to determine whether TGD individuals’ likelihood of reporting delays in care and positive healthcare provider interactions differs from that of cisgender people. Methods: We analyzed survey data from 89,133 participants who enrolled in the National Institutes of Health’s All of Us Research Program from 5/6/2018 to 4/1/2021. Unadjusted and adjusted logistic regressions were performed to assess the association of gender with delays in care in the past 12 months and provider interactions. Results: After adjustment, TGD individuals were more likely than cisgender men to report eight of nine reasons for care delays and more likely than cisgender women to report two of nine reasons. TGD individuals were more likely than cisgender men (OR 2.20, 95%CI 1.88-2.58, p<.001) or women (OR 1.45, 95%CI 1.24-1.70) to report delaying care for any reason enquired about on the survey. TGD individuals were less likely than cisgender men to report all three types of positive healthcare provider interactions and were less likely than cisgender women to report two of three types of positive interactions. Conclusion: Our findings indicate that TGD individuals may be more likely than cisgender people to experience delays in care and less likely to experience positive healthcare provider interactions. This suggests a critical need to increase TGD individuals’ access to supportive, culturally competent healthcare providers.
Keywords: gender diverse, transgender, delays in care, healthcare provider interactions, Barriers to care
Received: 14 Aug 2025; Accepted: 29 Oct 2025.
Copyright: © 2025 Hill, Carrasquillo, Medina Laabes and Colon-Lopez. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Katherine A Hill, hill.katherine2@mayo.edu
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