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Trans and gender diverse people’s experiences and evaluations with general and trans-specific healthcare services: a cross-sectional survey


Research into access to and experiences with healthcare services of gender-diverse and trans individuals remains scarce. In this paper, self-reported experiences with general and trans-specific healthcare services were analyzed for differences between gender-diverse people, trans men, and trans women, using data from a five-country survey. More than half of all respondents indicated they had delayed general healthcare services at least once because of their gender identity, mostly out of fear of being treated badly. Almost one in four participants felt personally discriminated against in general healthcare services within the previous year. Gender-diverse people had significantly less experiences with seeking trans-specific healthcare. Additional effects were found for different socio-demographic variables (age; sex assigned at birth; educational level; socioeconomic status; and belonging to an ethnic, sexual, and/or disability minority). Gender-diverse people gave significantly worse evaluations of trans-specific healthcare services (in general as well as for specific types of trans-specific healthcare). The findings highlight the need for healthcare providers in creating inclusive healthcare settings, with attention for gender-diverse clients and those belonging to precarious minority groups due to their level of education or sexual, disability, and/or ethnic background.

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Data availability

Restrictions apply to the availability of the data. Data were obtained from Transgender Europe and are available from the authors with the permission of Transgender Europe.


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The questionnaire development and data collection were coordinated by Transgender Europe (TGEU) using the framework of their project “Trans Health Study”, in close collaboration with its partner organizations “Women’s Initiative Supportive Group” (WISG) (Georgia), “Trans-Fuzja” (Poland), “Daniela Fundación” (Spain), “Geten” (Serbia), and the “Riksförbundet för homosexuellas, bisexuellas, transpersoners, queeras och intersexpersoners rättigheter” (RFSL) (Sweden). The authors acknowledge the work done by these organizations.


The study was funded by Transgender Europe.

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Correspondence to Joz Motmans.

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The authors declare no competing interests.

Institutional review board statement

The study was conducted according to the guidelines of the Declaration of Helsinki. No specific ethical approval was applied for since general ethical research principles in data gathering and data storage were followed, according to the Belgian law regarding experiments on humans (Wet inzake experimenten op de menselijke persoon). Potential participants were informed about the topics of the survey, the aim of the survey and the parties involved in the data gathering and analytical process, and had to give their explicit consent before they were able to proceed with the online survey.

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Burgwal, A., Motmans, J. Trans and gender diverse people’s experiences and evaluations with general and trans-specific healthcare services: a cross-sectional survey. Int J Impot Res 33, 679–686 (2021).

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