Foregone Healthcare: A Secondary Analysis of Survey Data on the Experiences of a Sample of Transgender and Non-Binary in Nova Scotians

Introduction: Previous international research has identified transgender and non-binary populations have poor health outcomes, due in part to foregone healthcare.Objective: This study focuses on examining the healthcare challenges in accessing gender-affirming care among a sample of transgender and non-binary Nova Scotians, and how these experiences may contribute to foregone healthcare.Methods: This research utilized secondary data analysis of a subset of data from an existing province-wide online survey was conducted of transgender and non-binary Nova Scotians. The methodology of this study employs both descriptive statistics and thematic analysis of close-ended and open-ended survey response categories. The socioecological model was used as the conceptual framework to describe the various levels of influence contributing to foregone healthcare among this population.Results: Three main themes emerged from the data, including fear of discrimination leading to decreased quality of care, poor availability of transgender and non-binary specific health services, and perceived or actual low levels of cultural competency among healthcare providers.Conclusion/Discussion: These factors contributed to foregone healthcare within this population which in turn led to a number of recommendations to improve patient-provider interactions. Specifically, we recommend additional resources and training for health care providers and trainees to improve their cultural competency in providing gender-affirming care.