Category: Gay / Lesbian / Bisexual / Transgender Issues


Access to Trans Health Care in Rural Alabama: Challenges in the Deep South

Friday, November 17
1:45 PM - 3:15 PM
Location: Sapphire Ballroom B, Level 4, Sapphire Level

Keywords: L / G / B / T | Cross Cultural / Cultural Differences | Stigma
Presentation Type: Symposium

Trans people living in Alabama face tremendous challenges when accessing health care, and when they do, it is rarely trans-affirming. These challenges are compounded for trans-specific services, especially for rural residents. To date, national calls for better LGBT-specific care (e.g., Healthy People 2020) have gone relatively unheeded. To understand the nature of these challenges, a needs assessment of trans healthcare services is necessary. This talk will present the first step in this direction. Using Alabama as a case study of the Deep South, we will review access barriers facing healthcare in rural areas of Alabama, focusing on mental health and supplemented by additional data.

Our theoretical approach features the Institute of Medicine’s categorization of barriers (2009) and extends these by integrating the system-level view in the Penchansky-Thomas Model of Barriers to Health Care Use (1981), which separates barriers into Affordability (IOM Financial), Accessibility and Availability (IOM Structural), and Accommodation and Acceptability (IOM Personal).

Data will demonstrate the serious needs in Alabama related to HEALTH (ranked 49th among states in health outcomes by UHI), MENTAL HEALTH (ranked 45th by MHA), HEALTH INSURANCE, provider and service SHORTAGES (particularly in its many rural areas), and DISTANCE TO CARE. Most of the state is HRSA-designated as medically underserved or a health professional shortage area, which ranks it 43rd in access to care.

These are separate from challenges related to culture-specific barriers to care, particularly mental health. Data will highlight the challenges for individuals seeking affirming care due to the limited number of individuals able or willing to treat them. For example, intake forms for 12 avowedly trans mental health providers, only 25% had affirming choices for Gender/Sex and only half mentioned a provider focus on trans services. The Gay and Lesbian Medical Association only lists 6 LGBT-affirming health providers for the entire state, and only 94 therapists designated a willingness to treat trans issues. System-level data will be enriched with the personal experiences of two rural LGBT minorities and their challenges obtaining care.

Joshua C. Eyer

Assistant Professor
The University of Alabama


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Access to Trans Health Care in Rural Alabama: Challenges in the Deep South

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