Gender-Affirming Primary Care Access Among Rural Transgender and Gender Diverse Adults in Five Northeastern U.S. States.

Purpose: Little is known about the prevalence and predictors of gender-affirming primary care (GAPC) access among rural transgender and gender diverse (TGD) adults. This study therefore sought to characterize the prevalence and predictors of GAPC within a sample of rural TGD adults. Methods: A nonprobability convenience sample ( n  = 244) of rural TGD adults was recruited across five Northeastern U.S. states (Connecticut, Massachusetts, New Hampshire, New York, Vermont) and completed a health needs assessment from March 2019 to October of 2019. Results: Transgender women and men had higher odds of accessing GAPC than nonbinary and gender diverse respondents. Respondents aged 25-39 had higher odds of accessing GAPC than those 18-24 years old. Conclusion: This study found high prevalence of barriers to GAPC among rural TGD people, highlighting system-level improvement opportunities.