“We Are Doing the Absolute Most That We Can, and No One Is Listening”: Barriers and Facilitators to Health Literacy within Transgender and Nonbinary Communities

C. Riley Hostetter, Jarrod Call, Donald R. Gerke, Brendon T. Holloway, N. Eugene Walls and Jennifer C. Greenfield
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C. Riley Hostetter: Graduate School of Social Work, University of Denver, Denver, CO 80208, USA
Jarrod Call: Graduate School of Social Work, University of Denver, Denver, CO 80208, USA
Donald R. Gerke: Graduate School of Social Work, University of Denver, Denver, CO 80208, USA
Brendon T. Holloway: Graduate School of Social Work, University of Denver, Denver, CO 80208, USA
N. Eugene Walls: Graduate School of Social Work, University of Denver, Denver, CO 80208, USA
Jennifer C. Greenfield: Graduate School of Social Work, University of Denver, Denver, CO 80208, USA

IJERPH, 2022, vol. 19, issue 3, 1-16

Abstract: Transgender and nonbinary (TNB) individuals face disparities in nearly every aspect of health. One factor associated with poor health outcomes in other marginalized populations is health literacy, yet no identified studies examine health literacy in TNB samples. Moreover, most health literacy frameworks focus primarily on the capacities of individual patients to understand and use healthcare information, with little attention given to provider literacy and environmental factors. In partnership with a statewide LGBTQ advocacy organization, we recruited 46 transgender and nonbinary individuals to participate in seven focus groups conducted in urban, suburban, and rural locations throughout Colorado. TNB participants consistently engaged in efforts to increase their own health literacy and that of their medical providers yet faced multiple barriers to improve care. Difficulty identifying and physically reaching care, insurance and out-of-pocket expenses, negative experiences with healthcare providers and staff, provider incompetence, discriminatory and oppressive practices, and exclusionary forms and processes emerged as barriers to enacted health literacy among participants. Conversely, facilitators of enacted healthcare literacy included positive experiences with healthcare providers and staff, and inclusive forms and processes.

Keywords: health literacy; transgender and nonbinary health; barriers to care; facilitators to care; healthcare (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (2)

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