“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
Graduate School of Social Work
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
Hostetter, C. Riley; Call, Jarrod; Gerke, Donald R.; Holloway, Brendon T.; Walls, N. Eugene; and Greenfield, Jennifer C., "“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" (2022). Graduate School of Social Work: Faculty Scholarship. 163.
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This article was originally published as:
Hostetter, C.R., Call, J., Gerke, D.R., Holloway, B.T., Walls, N.E., & Greenfield, J.C. (2022). “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. International Journal of Environmental Research and Public Health, 19(3), 1229. doi: 10.3390/ijerph19031229
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